bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilateral eye patching may improve clinical outcomes for acute primary rhegmatogenous retinal detachment
Authors: Tang Peter H. , Curran Christian D. , Salman Ali R. , Sodhi Guneet S. , Vagaggini Tommaso , Haq Zeeshan , Mittra Robert A. , Dev Sundeep , Emerson Geoffrey G. , Parke 3rd D. Wilkin , Quiram Polly A. , Belin Peter J. , Sastry Ananth , Ryan Edwin H. 
Published: November 2023

Abstract

Purpose:
Evaluate preoperative bilateral eye patching (BEP) on subretinal fluid (SRF) and vision in acute primary rhegmatogenous retinal detachments (RRD).

Methods:
Retrospective non-randomized interventional study of 335 RRD patients undergoing BEP until surgery (BEP cohort) and separated by % full-time compliance: high (≥ 90%), medium (> 90% but ≥ 50%), and low (< 50%). Those declining BEP were included (control). All underwent surgery and followed for ≥ 3 months. Imaging was obtained immediately prior to surgery (iPTS). Best-corrected visual acuity (BCVA) was measured at longest follow-up and iPTS. SRF and foveal status iPTS were analyzed.

Results:
240 and 95 patients were in BEP and control cohorts, respectively. 30 patients presented iPTS for analysis. High (64%) and medium (35%) compliance showed significantly greater (P < 0.01) SRF reduction compared to low (4%) and control (3%). Mac-off RRD showed significantly greater (P < 0.01) foveal reattachment with high (29%) and medium (8%) compliance compared to low (2%) and control (1%). Mac-on RRD demonstrated no significant differences (P ≥ 0.51) in final BCVA among high (0 logMAR [median], 20/20 Snellen), medium (0.10 logMAR, 20/25 Snellen), low (0.10 logMAR), and control cohorts (0.10 logMAR). Mac-off RRD demonstrated significantly better final BCVA with high compliance (0.30 logMAR, 20/40 Snellen) compared to low (0.40 logMAR, 20/50 Snellen; P = 0.04) and control (0.60 logMAR, 20/80 Snellen; P = 0.02).

Conclusions:
Preoperative BEP can stabilize or improve SRF in acute primary RRD. Patients with BEP >50% of time experienced greatest benefits.
Characteristics Predictive of Fellow-Eye Geographic Atrophy without Neovascularization in Unilateral Type 3 Macular Neovascularization
Authors: Kim Jae Hui , Kim Jong Woo , Kim Chul Gu 
Published: November 2023

ABSTRACT

Purpose:
To evaluate the predictive characteristics of fellow-eye geographic atrophy (GA) without neovascularization in patients with unilateral type 3 macular neovascularization (MNV).

Methods:
This retrospective study included 84 patients who were diagnosed with unilateral type 3 MNV. Patients who developed fellow-eye neovascularization and those exhibiting GA without neovascularization at the final follow-up were included in the NV and GA groups, respectively. The patient demographics and baseline fellow-eye characteristics were compared between the two groups.

Results:
The mean follow-up period was 40.5±11.5 months after diagnosis. Patients included in the GA group (n = 28) were significantly older (mean 77.4 ± 5.2 years vs. 74.2 ± 5.8 years, P = 0.016), had significantly thinner subfoveal choroidal thickness (SCT; mean 109.4 ± 36.8 µm vs. 173.1 ± 77.6 µm, P < 0.001), and had a significantly higher incidence of baseline GA (39.3% vs. 16.1%, P = 0.019) than those included in the NV group (n = 56). In the multivariate analysis, SCT showed a close negative association with the risk of GA rather than neovascularization (P = 0.004, β = 0.982, 95% confidence interval = 0.970–0.994).

Conclusions:
In patients with unilateral type 3 MNV, older age, the presence of GA, and a thin choroid in the fellow eye were found to be indicative of a higher probability of progression towards fellow-eye GA instead of neovascularization may be potential candidates for future complement inhibitor treatments targeting fellow-eye GA.
TRANSDIFFERENTIATION AND INTRACHOROIDAL MIGRATION OF MELANOTIC RETINAL PIGMENT EPITHELIUM IN PUNCTATE INNER CHOROIDITIS
Authors: Bijon Jacques , Freund K. Bailey 
Published: November 2023

Purpose:
The objective of this study was to report the multimodal imaging features of hyperpigmented chorioretinal lesions originating from the retinal pigment epithelium within punched-out lesions of punctate inner choroidopathy.

Methods:
This was a retrospective case report. Multimodal imaging findings including fundus photography, optical coherence tomography, and optical coherence tomography–angiography were analyzed.

Results:
A 49-year-old woman with myopic degeneration developed progressive lesions of punctate inner choroidopathy, requiring immunosuppressive therapy with adalimumab. Within the areas of punched-out chorioretinal atrophic lesions, the occurrence of hyperpigmented lesions was observed, which enlarged and extended into the choroid over a multiyear follow-up.

Conclusion:
This case illustrates the development of pigmented choroidal lesions appearing to originate from the retinal pigment epithelium through transdifferentiation after previous chorioretinal inflammatory lesions. The introduction of adalimumab treatment may have activated the cellular migration of the retinal pigment epithelium. To the best of the authors' knowledge, this is the first report of intrachoroidal retinal pigment epithelium migration in punctate inner choroidopathy.
BELZUTIFAN FOR TREATMENT OF GIANT RETINAL HEMANGIOBLASTOMA WITH EXTRASCLERAL EXTENSION ASSOCIATED WITH VON HIPPEL–LINDAU SYNDROME
Authors: Cotton Caroline C. , Chandrabhatla Anirudha S. , Andrews Patrick H. , Purrow Benjamin W. , Shildkrot Yevgeniy (Eugene) 
Published: November 2023

Purpose:
To describe the clinical response and safety profile of the novel HIF-2ɑ inhibitor belzutifan in treating a giant retinal hemangioblastoma with extrascleral extension associated with von Hippel–Lindau syndrome.

Methods:
A 71-year-old woman with Von Hippel–Lindau syndrome presented with a giant retinal hemangioblastoma with extrascleral extension in her only remaining eye. She had no light perception in the right eye and intraocular pressure was 48. She requested enucleation because of chronic pain, but because of concern for significant bleeding given the size of the neoplasm, a trial of belzutifan was initiated.

Results:
Within 3 months of treatment initiation, the patient reported an 80% reduction in pain. Magnetic resonance imaging showed 30% reduction in longest tumor diameter. Dose adjustments were guided by serum hemoglobin levels, allowing the patient to remain on the medication for over a year with continued tumor regression on MRI and avoid enucleation.

Conclusion:
Retinal hemangioblastoma with extrascleral extension is exceedingly rare and its treatment is complex, often requiring enucleation or external beam radiotherapy. This report demonstrates the use of belzutifan to safely and successfully reduce ocular tumor burden of complicated retinal hemangioblastoma with extrascleral extension, ultimately decreasing the need for enucleation.
Recent Fluctuations in Public Searches for Cosmetic Procedures as Shown by Google Trends
Authors: Oh Angela J. , Rootman Daniel B. 
Published: November 2023

Purpose:
The goal of this study is to understand the dynamic trends of 20 cosmetic procedures in the United States using Google Trends.

Methods:
This was a descriptive cross-sectional study using Google Trends to measure changes in search volumes for 20 cosmetic procedures from a 5-year period (2018 to 2023) in the United States. Outcome measures included total and weekly changes in relative search volumes and variance levels for the following 20 search terms related to cosmetic surgeries: blepharoplasty, botox, breast augmentation, breast lift, brow lift, buccal fat removal, chemical peel, dermal filler, face lift, hair removal, hair transplant, lip filler, liposuction, masseter botox, microneedling, otoplasty, photofacial, rhinoplasty, tear trough filler, and tummy tuck. Search terms were divided into 3 categories, a) those with a change of public interest over a single week of 25% or less, b) 26%–50%, and c) greater than 50%.

Results:
There was an overall 5-year increase of public interest in all but 5 search terms: breast augmentation, breast lift, liposuction, photofacial, and tummy tuck. Within a single week, lip filler, masseter botox, buccal fat removal, and tear trough filler exhibited greater than 50% change in public interest, while public interest in microneedling, hair removal, rhinoplasty, tummy tuck, liposuction, breast lift, and augmentation were more stable with less than 26% change.

Conclusions:
While certain procedures may experience rapid accelerations in public interest, not all procedures will consistently increase in popularity. Physicians must recognize the shifting popularity of cosmetic procedures to provide informed cosmetic care to patients.
Teprotumumab and Orbital Decompression for the Management of Proptosis in Patients With Thyroid Eye Disease
Authors: Hubschman Sasha , Sojitra Badal , Ghiam Sean , Sears Connie , Hwangbo Nathan , Goldberg Robert A. , Rootman Daniel B. 
Published: November 2023

Purpose:
To compare outcomes of patients with thyroid eye disease treated with teprotumumab or orbital decompression, or both in sequence.

Methods:
Patients with thyroid eye disease and treated with decompression, teprotumumab, or both were included. Four groups were defined: decompression only, teprotumumab only, teprotumumab first with decompression later, and decompression first with teprotumumab later. The primary outcome was change in exophthalmometry. Secondary outcomes included change in extraocular muscle motility, strabismus, diplopia, and side effects.

Results:
One hundred and thirty-nine patients were included. The mean duration for early follow-up was 1.2 months for both decompression and teprotumumab groups. The mean late follow-up was 14.4 and 8.2 months for the decompression and teprotumumab groups respectively. Mean change in exophthalmometry was significantly greater for the decompression group (3.5 mm) compared with teprotumumab (2.0 mm) at late follow-up. Improvement in total extraocular muscle restriction was significantly greater in the teprotumumab group (14.7 degrees) than in the decompression group (2.6 degrees). The teprotumumab group had a significantly higher percentage of patients with diplopia score >1 at baseline and late follow-up (p < 0.01) compared with the decompression group. Additional treatment with teprotumumab or decompression when previously treated with the opposite had similar proptosis reduction effect as that therapy alone.

Conclusions:
Surgical decompression has a greater proptosis reduction effect than teprotumumab, whereas teprotumumab better improves extraocular muscle motility. The addition of teprotumumab or decompression to a previous course of the opposite adds a similar effect to the supplemental treatment alone.
ENABLE-LVAD
Authors: Pfahl Jamie , Thompson Jocelyn S. , Matlock Daniel D. , Allen Larry A. , Dionne-Odom J. Nicholas , Bakitas Marie A. , McIlvennan Colleen K. 
Published: November 2023

Background
Despite significant family caregiver (FCG) burnout, there are currently no tested interventions to support the FCG role after left ventricular assist device (LVAD) implantation or formalized training for clinicians to support FCGs.

Objective
We adapted the existing ENABLE (Educate, Nurture, Advise Before Life Ends) intervention to LVAD clinicians and FCGs and assessed clinical implementation and dissemination.

Methods
ENABLE-LVAD is an interactive, self-paced clinician training coupled with FCG-facing guidebooks and resources. Implementation and dissemination were evaluated by the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework.

Results
As of May 2023, 187 clinicians registered for the training, and 41 completed all modules (22.0% completion rate). Of those who completed the training and responded to a 6-month survey, one-third (n = 10, 33.3%) used ENABLE-LVAD with FCGs, and 100% of those planned to continue using it. The primary barrier to completing the training was time.

Conclusions
The ENABLE-LVAD clinician training was successfully disseminated and implemented as a useful resource to support LVAD FCGs.
Differences Between Clients and Professionals of Forensic and Nonforensic Flexible Assertive Community Treatment
Authors: Clercx Maartje , van Tuijn Genevieve 
Published: November 2023

ABSTRACT

Rationale
Flexible assertive community treatment (FACT) has been adapted for application with clients with criminal justice involvement (forensic FACT [ForFACT]). Differences have been found between clients of ForFACT services and clients of nonforensic FACT services; however, less is known about differences in behaviors. Furthermore, because of the different guiding frameworks and goals of treatment, and the difference in clients' presenting problems, it is possible professionals also differ in terms of specialist skills they need and in areas of care they deem important.

Method
The current study used an online survey among professionals of ForFACT and non-ForFACT teams to gain insight into mental disorders and clients' presenting behavioral problems and to gain insight into the level of forensic vigilance needed by professionals of both services. We also gathered information pertaining to important areas of care and what both groups of professionals view as key nursing interventions.

Results
ForFACT clients differ from non-ForFACT clients in terms of the clients' presenting psychiatric problems. Furthermore, ForFACT professionals indicated they encounter more clients who show aggressive and (sexually) transgressive behavior. ForFACT professionals were found to score higher on forensic vigilance; however, no differences pertaining to important areas of care and key nursing interventions were found.

Conclusion
These findings further strengthen the notion that ForFACT clients are a different group compared with non-ForFACT clients, and professionals need different skills. Organizations could provide tailored supervision and training to ForFACT professionals.
Conservative Management of Partial Thickness Rotator Cuff Tears: A Systematic Review
Authors: Longo Umile Giuseppe , Lalli Alberto , Medina Giovanna , Maffulli Nicola 
Published: November 2023

Background:
Conservative management has emerged as an attractive option for partial thickness rotator cuff tears (PT-RCTs). A single algorithmic treatment strategy for patients with symptomatic PT-RCT has not yet been developed. This systematic review aims to ascertain whether a conservative approach to PT-RCTs yields positive results in terms of clinical outcomes and functional recovery.

Methods:
This is a systematic review of the literature on patients with PT-RCTs receiving conservative treatment with physiotherapy, platelet-rich plasma (PRP) injections, collagen injections, hyaluronic acid (HA) injections, or corticosteroids injections coupled with polydeoxyribonucleotide (PDRN). Outcomes such as the Visual Analog Scale (VAS) for pain, American Shoulder and Elbow Surgeons and Constant-Murley Score evaluations, as well as the Shoulder Pain and Disability Index and Euro Quality of Life-5D questionnaires were reported following a conservative approach.

Results:
Eleven studies were included. Six articles explored the outcomes of patients with PT-RCT treated with PRP injections. Significant improvements in VAS for pain were observed. Two studies examined collagen injections and reported variations in VAS for pain and Constant-Murley Score. Sodium hyaluronate and HA injections were studied in two other articles, showing notable improvements in American Shoulder and Elbow Surgeons scores. Corticosteroid and PDRN injections also displayed favorable outcomes. In addition, physical therapy protocols demonstrated improvements in VAS for pain and strength, particularly with eccentric rehabilitation.

Conclusions:
Conservative management of PT-RCTs, involving physical therapy, PRP injections, collagen injections, corticosteroid injections, HA injections, and PDRN in jections, demonstrates favorable clinical outcomes. In addition, favorable results are observed in terms of decreased tear width and improved strength recovery, at least during a short-term follow-up. Unfortunately, long-term insight into the structural integrity of conservatively treated rotator cuff tendons following a partial injury has not been thoroughly evaluated yet.

Study Design; Levels of Evidence:
Level IV—systematic review.
Prediction of axillary lymph node metastasis using tumor volume to breast volume ratio: retrospective cohort study
Authors: Chatmongkonwat Tanet , Phool Wongpipat , Ruengwongroj Patchara , Khiewcharoen Naddakan , Aroonasirakul Pornchai , KittiJaroenwong Vatchara , Lukkraisorn Satit , Napaaumpaiporn Rungarun 
Published: November 2023

Background:
Tumour size appear to be a risk factor of axillary lymph node metastasis in breast cancer. Recent evidence shows that higher the T staging is associated with higher rate of axillary lymph node metastasis. However, no studies shows that in the same T staging or tumour size but different breast size or breast volume the incidence of axillary lymph node metastasis differ or not .

Objectives:
This Study aimed to investigate the association between tumour to breast ratio in breast cancer as a predictive factor of axillary lymph node metastasis

Methods:
This study included 200 consecutive patients diagnosed with breast cancer between January 2012 to march 2022. The authors retrospectively reviewed medical data pathologic report and Ultrasonography and mammography of breast. Tumour diameter reported in pathologic report was used to calculate tumour volume using formula for ellipse. Breast volume was calculate using formula referencing from study of Jack W. Rostas et all by formula Breast Volume=1/3×¶×Radius2ccview×Heightccview by measuring from mammography of patient. Tumour volume to breast volume ratio was calculated and analyzed

Result:
Of 200 patient included in this study, 84 patient (42%) was in lymph node positive group and 116 patient (58%) was in lymph node-negative group. Median for tumour and breast volume ratio in node positive group was higher [median 0.0093 (interquartile range=0.0047–0.023)] than in node-negative group [median 0.0065 (interquartile range (0.0028–0.0199)]. P=0.0414 receiver operating characteristic curve for tumour to breast ratio showed AUC of 0.7389 (95% CI 0.67993–0.82335) Which seems to be a significance as predictive factors for Axillary lymph node metastasis

Conclusion:
Higher tumour volume to breast volume ratio tends to be a significance predictive factors for axillary lymph node metastasis in breast cancer patients
Breast cancer’s hidden partner: meningoencephalitis as a paraneoplastic revelation: a rare presentation of invasive ductal carcinoma of breast: a case report
Authors: Gul Muhammad Hamza , Arooj Hajira , Siddiqui Aisha , Abdullah Lava , Waseem Zainab , Hashmi Muhammad Usman 
Published: November 2023

Introduction and importance:
Paraneoplastic neurologic syndromes encompass a group of neurologic disorders arising from pathological processes unrelated to metastasis, metabolic disturbances, infections, coagulopathy, or treatment-related side effects. These syndromes can affect various regions of the nervous system, resulting in diverse clinical manifestations

Case presentation:
The authors present a rare case of anti-amphiphysin-associated meningoencephalitis in a South Asian Pakistani woman. Initially, the patient was managed for suspected infectious meningitis, but empirical treatment failed to yield improvement. Subsequent investigations unveiled a paraneoplastic syndrome secondary to breast cancer.

Discussion:
Diagnosing these clinical entities is challenging due to their multifaceted presentations, often leading to delayed identification, increased patient suffering, economic burdens, and preventable complications.

Conclusion:
Anti-amphiphysin-associated meningoencephalitis is a rare manifestation of paraneoplastic syndromes. It is crucial to raise awareness among healthcare professionals about the diverse presentations of paraneoplastic syndromes.
Amoxicillin-induced bullous erythema multiforme: a case report
Authors: Sitaula Seema , Shah Bikash K. , Kharel Sanjeev , Yadav Alisha , Poudel Nahakul , Shrestha Bhusan 
Published: November 2023

Introduction:
Bullous erythema multiforme (BEM), an immune-mediated, acute condition, frequently includes erosion affecting the oral, genital, and/or ocular mucosa in addition to discrete target-like lesions on the skin. BEM has been linked to various factors, including infections, medications, malignancy, autoimmune disease, immunization, and radiation.

Case presentation:
Here, we report a case of a 38-year-old married woman who presented with symptoms of reddish-raised, fluid-filled and painful, nonpruritic lesions along with the swelling of bilateral hand and feet. This patient had a history of taking some unrecorded ayurvedic medication for bloating and abdominal pain in a background of antibiotic use before exhibiting the dermatological symptoms of BEM 2 days later. She was successfully managed with ampicillin and cloxacillin, acyclovir and prednisolone.

Clinical discussion:
A few incidence of BEM after the administration of amoxicillin has been reported, which precipitated only after consuming ayurvedic medication. BEM has a clinical diagnosis with biopsy rarely required. Here, the hypersensitivity reaction induced by the antibiotic itself or by altering the immune response to the concomitant consumed herbal medicine could explain the BEM.

Conclusion:
Physicians should note that amoxicillin can trigger BEM, regardless of its use with ayurvedic drugs. Antibiotics should be used with caution, especially in patients with a history of BEM.
Evaluation of Pediatric Readiness Using Simulation in General Emergency Departments in a Medically Underserved Region
Authors: Rutledge Chrystal , Waddell Kristen , Gaither Stacy , Whitfill Travis , Auerbach Marc , Tofil Nancy 
Published: November 2023

Background
Regionalization of pediatric care in the United States was developed to improve care by directing patients to hospitals with optimal pediatric resources and experience, leading to less pediatric-trained providers in medically underserved areas. Children with emergencies, however, continue to present to local general emergency departments (GEDs), where pediatric emergencies are low-frequency, high-risk events.

Objective
The goals of this project were to: increase exposure of GEDs in the southeast United States to pediatric emergencies through simulation, assess pediatric emergency clinical care processes with simulation, describe factors associated with readiness including volume of pediatric patients and ED location (urban/rural), and compare these findings to the 2013 National Pediatric Readiness Project.

Methods
This prospective in situ simulation study evaluated GED readiness using the Emergency Medical Services for Children Pediatric Readiness Score (PRS) and team performance in caring for 4 simulated pediatric emergencies. Comparisons between GED and pediatric ED (PED) performance and PRS, GED performance, and PRS based on pediatric patient volume and hospital location were evaluated. A Composite Quality Score (CQS) was calculated for each ED.

Results
Seventy-five teams from 40 EDs participated (39 GED; 1 PED). The PED had a significantly higher volume of pediatric patients (73,000 vs 4492; P = 0.003). The PRS for GEDs was significantly lower (57% [SD, 17] vs 98%; P = 0.022). The CQSs for all GEDs were significantly lower than the PED (55% vs 87%; P < 0.004). Among GEDs, there was no statistically significant difference in PRS or CQS based on pediatric patient volume, but urban GEDs had significantly higher CQSs versus rural GEDs (59.8% vs 50.6%, P = 0.001).

Conclusions
This study shows a significant disparity in the performance and readiness of GEDs versus a PED in a medically underserved area. More education and better access to resources is needed in these areas to adequately care for critically ill pediatric patients.