bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unique pathways downstream of TLR-4 and TLR-7 activation: sex-dependent behavioural, cytokine, and metabolic consequences
Authors: Dunstan Isobel K. , McLeod Ross , Radford-Smith Daniel E. , Xiong Wenzheng , Pate Trinity , Probert Fay , Anthony Daniel C. 
Published: February 2024

IntroductionPost-infection syndromes are characterised by fatigue, muscle pain, anhedonia, and cognitive impairment; mechanistic studies exploring these syndromes have focussed on pathways downstream of Toll-like receptor (TLR) 4 activation. Here, we investigated the mechanistic interplay between behaviour, metabolism, and inflammation downstream of TLR-7 activation compared to TLR-4 activation in male and female CD1 mice.MethodsAnimals received either a TLR-4 (LPS; 0.83 mg/kg) or TLR-7 (R848, 5 mg/kg) agonist, or saline, and behaviour was analysed in an Open Field (OF) at 24 h (n = 20/group). Plasma, liver, and prefrontal cortex (PFC) were collected for gene expression analysis at 24 h and 1H-NMR metabolomics.ResultsTLR-4 and TLR-7 activation decreased distance travelled and rearing in the OF, but activation of each receptor induced distinct cytokine responses and metabolome profiles. LPS increased IL-1β expression and CXCL1 in the PFC, but TLR7 activation did not and strongly induced PFC CXCL10 expression. Thus, TLR7 induced sickness behaviour is independent of IL-1β expression. In both cases, the behavioural response to TLR activation was sexually dimorphic: females were more resilient. However, dissociation was observed between the resilient female mice behaviour and the levels of gene cytokine expression, which was, in general, higher in the female mice. However, the metabolic shifts induced by immune activation were better correlated with the sex-dependent behavioural dimorphisms; increased levels of antioxidant potential in the female brain are intrinsic male/female metabolome differences. A common feature of both TLR4 and TLR7 activation was an increase in N-acetyl aspartate (NAA) in the PFC, which is likely be an allostatic response to the challenges as sickness behaviour is inversely correlated with NAA levels.DiscussionThe results highlight how the cytokine profile induced by one PAMP cannot be extrapolated to another, but they do reveal how the manipulation of the conserved metabolome response might afford a more generic approach to the treatment of post-infection syndromes.
Tonghua Liyan granules in the treatment of Laryngopharyngeal reflux disease with stagnation of phlegm and qi syndrome: a randomized, double-blind, placebo-controlled study
Authors: Li Yading , Zheng Mingxian , Wang Yi , Xu Gaofan , He Yunyun , Wu Yue , Wang Xiao , Liu Yuyang , Jiang Yujie , Liu Xiaowen , Meng Yangyang , Yap Yixuan , Zhu Shengliang , He Cong , Zhou Bingduo 
Published: February 2024

Background: Laryngopharyngeal reflux disease (LPRD) is an extraesophageal syndromic manifestation of gastroesophageal reflux disease (GERD). Despite the increasing incidence of and concern about LPRD, treatment with proton pump inhibitors (PPIs) is unsatisfactory. Here, LPRD was treated with Tonghua Liyan (THLY) granules in combination with PPIs to evaluate treatment efficacy and possible adverse reactions.Methods: Seventy-six LPRD patients with stagnation of phlegm and qi syndrome (SPQS) were randomly divided into an experimental group and a control group. The experimental group received THLY granules combined with rabeprazole capsules. The control group received THLY granule placebo combined with rabeprazole capsules. A parallel, randomized, double-blind, placebo-controlled clinical trial was conducted with these two groups. The treatment cycle was 8 weeks. The reflux symptom index (RSI), clinical symptom score, salivary pepsin content, reflux finding score (RFS) and gastroesophageal reflux disease questionnaire (GerdQ) were used to evaluate clinical efficacy. The final efficacy rate was evaluated according to the RSI and clinical symptom score.Results: Compared with those at baseline, all the indicators in the experimental group and control group significantly improved (p &lt; 0.01). In terms of the RSI, clinical symptom score, and RFS, the experimental group had a higher degree of improvement (p &lt; 0.05), and the overall efficacy rate was higher (p &lt; 0.05). In terms of the salivary pepsin concentration and GerdQ, there was no significant difference between the test group and the control group (p &gt; 0.05). Both groups of safety indicators showed no abnormalities and did not cause any allergic reactions in the body.Conclusion: Compared with PPIs alone, THLY granules combined with PPIs are more effective in the treatment of LPRD patients with SPQS in terms of symptoms and signs. This combination treatment, because of its higher clinical efficacy and lack of obvious adverse reactions, is worthy of clinical promotion and further in-depth study.Clinical Trial Registration:www.chictr.org.cn, identifier ChiCTR2100046614
Systematic review on intentional non-medical fentanyl use among people who use drugs
Authors: Tsang Vivian W. L. , Wong James S.H. , Westenberg Jean N. , Ramadhan Noor H. , Fadakar Hasti , Nikoo Mohammadali , Li Victor W. , Mathew Nick , Azar Pouya , Jang Kerry L. , Krausz Reinhard M. 
Published: February 2024

ObjectivesFentanyl is a highly potent opioid and has, until recently, been considered an unwanted contaminant in the street drug supply among people who use drugs (PWUD). However, it has become a drug of choice for an increasing number of individuals. This systematic review evaluated intentional non-medical fentanyl use among PWUD, specifically by summarizing demographic variance, reasons for use, and resulting patterns of use.MethodsThe search strategy was developed with a combination of free text keywords and MeSH and non-MeSH keywords, and adapted with database-specific filters to Ovid MEDLINE, Embase, Web of Science, and PsychINFO. Studies included were human studies with intentional use of non-medical fentanyl or analogues in individuals older than 13. Only peer-reviewed original articles available in English were included.ResultsThe search resulted in 4437 studies after de-duplication, of which 132 were selected for full-text review. Out of 41 papers included, it was found that individuals who use fentanyl intentionally were more likely to be young, male, and White. They were also more likely to have experienced overdoses, and report injection drug use. There is evidence that fentanyl seeking behaviours are motivated by greater potency, delay of withdrawal, lower cost, and greater availability.ConclusionsAmong PWUD, individuals who intentionally use fentanyl have severe substance use patterns, precarious living situations, and extensive overdose history. In response to the increasing number of individuals who use fentanyl, alternative treatment approaches need to be developed for more effective management of withdrawal and opioid use disorder.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42021272111.
Use of rhodamine B as a biomarker in a simulated oral vaccine deployment against bovine tuberculosis in white-tailed deer
Authors: Dressel David , VerCauteren Kurt C. , Lavelle Michael J. , Snow Nathan P. , Campa Henry 
Published: February 2024

IntroductionFree-ranging white-tailed deer (Odocoileus virginianus) in northeastern lower Michigan, (United States) are a self-sustaining reservoir for bovine tuberculosis (bTB). Farm mitigation practices, baiting bans, and antlerless deer harvests have been ineffective in eliminating bTB in white-tailed deer and risks to cattle. The apparent prevalence has remained relatively constant in deer, prompting interest among wildlife researchers, managers, and veterinarians for an effective means of vaccinating deer against bTB. The commonly used human vaccine for bTB, Bacillus Calmette Guerin (BCG), is the primary candidate with oral delivery being the logical means for vaccinating deer.Materials and methodsWe developed vaccine delivery units and incorporated the biomarker Rhodamine B before delivering them to deer to assess the level of coverage achievable. Following deployment of Rhodamine B-laden vaccine delivery units on 17 agricultural study sites in Alpena County, MI in Mar/Apr 2016, we sampled deer to detect evidence of Rhodamine B consumption.Results and discussionWe collected a total of 116 deer and sampled them for vibrissae/rumen marking and found 66.3% (n = 77) of the deer collected exhibited evidence of vaccine delivery unit consumption. Understanding the level of coverage we achieved with oral delivery of a biomarker in vaccine delivery units to deer enables natural resource professionals to forecast expectations of a next step toward further minimizing bTB in deer.
Augmented Surgical Treatment in Patient with Partially Accomodative Esotropia
Authors: PRADISTYA SYIFA YUDIASARI  , Feti Karfiati  , Mayasari Wahyu Kuntorini  , Irawati Irfani  , Primawita Oktarima  , Sesu Caesarya  
Published: February 2024

Introduction : Esotropia is a disorder of the position of the eyeball when the eye deviates inward. Surgical treatment is indicated when the eyes are not aligned with the glasses. We report a case of augmented surgical treatment in a partially accommodative esotropia patient.
Case Illustration : A 18-year-old girl comes to the hospital with vision loss in both eyes since 1 year prior admission. Ocular alignment sinne correction was 300 (Figure 1) and cum correction was 150. Prism alternate cover test (PACT) showed deviation in sinne correction distance 60?BO dan near 50?BO, and deviation in cum correction distance 40?BO dan near 35?BO. Surgical formula with augmented surgery was (60?BO + 40?BO)/2 equal to 50?BO. Patient was diagnosed with Compositus Hypermetropia ODS + Partially Accommodative Esotropia. Patient underwent bilateral medial rectus recess surgery of 6 mm. Ophthalmology examination after 1 and 2.5 month surgery showed ocular alignment without spectacles showed microtropia and with spectacles showed orthotropia (Figure 2, 3a and 3b).
Discussion : Various approaches can improve outcomes, including using different surgical formulas. Augmented surgery are the mean of deviation with and without surgery as the final deviation surgical formula.
Conclusion : The amount of surgery in strabismus was based on the size of preoperative deviation. Augmented surgical treatment can be one of the choices to determine preoperative deviation in an esotropia patient.
RIGID GAS PERMEABLE USAGE IN AMBLYOPIC PATIENTS: IS IT SECURE ENOUGH?
Authors: Septian Dwi Prabowo  , Christina Aritonang  
Published: February 2024

Introduction : Amblyopia and anisometropia are frequently diagnosed during preschool. Several treatments approaches are currently being prescribed to reduce myopia progression, such RGP.
Case Illustration : A-17-years-old-patient came with blurry vision in both eyes since elementary school. Since Junior High School patient always felt un-comfort using spectacles and routinely check for 6 months. Initial visual acuity was 2/60 pinhole 5/30 and 4/60 pinhole 5/12 in the right and left eye. The previous spectacles were S-4.75 C-1.50 A0 become 5/20 and S-9.00 C-3.50 A0 become 5/6.5 in the right and left eye. After correction S-11.00 C-4.00 A180 become 5/6.5 and S-9.00 C-3.50 A0 become 5/6.5. Due to high myopia, RGP contact lenses were fitted. RGP contact lenses that are given to this patient were BC 8.10 mm/P -9.00D/ D 9.2mm in right eye, and BC 8.00 mm/ P -8.50D/ D 9.2mm in left eye, and visual acuity become 5/6.5 in both eyes.
Discussion : Management of anisometropia can be accomplished through a variety techniques. In cases of severe anisometropia, contact lenses are frequently utilized for refractive correction such as RGP, that is produced in a larger variety of powers, can fit in a certain base curve or diameter, has high oxygen permeability, improved durability, increased contrast sensitivity, and correct higher corneal astigmatism and decreased amblyopia
Conclusion : The risk-benefit and patients' low compliance haven't yet provided a definitive answer. RGP contact lens is secure and practical in the treatment of anisometropia and amblyopic patients. All of which are crucial for achieving the greatest vision and comfort possible following adaptation.
Managing Periorbital Necrotizing Fasciitis: How Invasive Should We Go?
Authors: Andi Marsa Nadhira  , Lia Amanda  , Muhammad Shafiq Advani  , Lukman Edwar  
Published: February 2024

Introduction : Periorbital necrotizing fasciitis (PNF) is rapidly progressive and severe infection that may result in vision loss, serious facial disfigurement, and death. Primary management includes surgical debridement; however, here we report a case in which conservative approach resulted in favorable resolution.
Case Illustration : A 24-year-old male presented with swollen right upper eyelid, with watery eye, pain, and blurry vision since 1 week prior. No history of trauma or known systemic diseases was reported. Restricted movement of the right eye (RE), slight nonaxial proptosis, and skin defect along the right superior palpebra with pus, blood, necrotic and granulation tissues were found. Visual acuity (VA) of RE decreased to 6/40 with normal intraocular pressure. No abnormalities on the left eye, fever, and other signs of systemic involvement were present. Contrast orbital computed tomography (CT) scan revealed right preseptal and postseptal tissue lesions, suggesting orbital cellulitis. Initial blood work showed leukocytosis, elevated neutrophil and lymphocyte counts, and high liver function markers. The diagnosis of right orbital cellulitis with PNF was established. Skin swabs and blood cultures were taken, while intravenous ampicillin-sulbactam, bedside wound debridement, and chloramphenicol ointment application were initiated. The swab culture later showed Acinetobactersp. The infection improved, VA was restored to 6/6, and wound closure was achieved without any surgery.
Discussion : Management of necrotizing fasciitis localized in periorbita in an otherwise healthy patient may be successfully accomplished with a less invasive approach.
Conclusion : Timely diagnosis and correct antibiotic therapy are mandatory to decrease morbidity and mortality related to PNF.
Bilateral Ocular Leprosy An Effect By Erythema Nodusum Leprosum : A Case Report
Authors: PETER SALMON  , Monica Camilla Chandra  , Elbetty Agustina br.Simanjuntak,MD  , Ivonne Ramenusa, MD  
Published: February 2024

Introduction : Leprosy or Hansen’s disease is an infection caused by Mycobacterium leprae that primarily affects the skin, the peripheral nerves and the eyes, causing chronic granulomatous inflammation.
Case Illustration : We present a case of lepromatous leprosy with erythema nodosum leprosum of a 47 years old man with bilateral and asymmetrical ocular complications. One year ago patient consumed multidrug therapy for leprosy for one year but didn’t finish the medication. On the right eye diagnose with chronic anterior and intermediate uveitis, on the left eye with panuveitis. Best corrected visual acuity (BCVA) was 2/60 for right eye and light perception for left eye. Intraocular pressure were within normal limits. Madarosis and corneal hypoesthesia were found on both eyes. On the right eye was found cells, synechia anterior and posterior, iris pearls and vitreous haze. On the left eye was found plasmoid iridocyclitis and vitreous opacities from USG. Slit skin smear (SSS) result positif acid fast bacilli (AFB) dan granular. Patients were treated with multidrug therapy for leprosy, topical antibiotics, atropine and steroids, oral antibiotics and treatment from a dermatologist.
Discussion : The diagnosis of lepromatous uveitis (LU) in this patient is made through skin tissue biopsy and ophthalmological examination. The effective management of ocular leprosy depends on early diagnosis and appropriate treatment. Hence it is imperative for ophthalmologist to recognize the ocular clinical signs associated with leprosy.
Conclusion : Most blindness and impaired vision resulting from leprosy is preventable. A multidisciplinary approach is to be taken in order to improve the prognosis.
CHALLENGING DIAGNOSIS AND MANAGEMENT OF INFECTIOUS SCLERITIS COMPLICATED WITH CORNEAL PERFORATION CAUSED BY MULTI DRUG RESISTANT Proteus mirabilis
Authors: Pranandito Trunogati  , Herwindo Dicky Putranto  , Rosy Aldina  
Published: February 2024

Introduction : Scleritis is a destructive inflammatory disease of sclera and may involve the cornea that associated with an underlying systemic disease and smaller minority are due to infections. The two conditions closely mimic each other, and diagnostic delay can lead to a poor outcome
Case Illustration : A 72 year old male presented with severe pain, redness, swelling, and dimness of vision in his left eye. On slitlamp examination, a superonasal scleral nodule with overlying conjunctival defect and corneal ulcer was found. Both ANA test and RA factor were negative. Microbiological investigations of the lessions revealed MDR Proteus mirabilis. His left eye rapidly deteriorated leading to an impending perforation of the sclera and corneal perforation despite intensive antimicrobial therapy, then patient underwent a tibial periosteal graft on his left eye. Although the visual prognosis was poor, structural integrity of the eye was achieved
Discussion : Infection is a rare cause of scleritis. Among the organism reported till date, Proteus mirabilis, a gram negative, rod shaped bacterium is the rarest to found. The inciting factors are mostly surgical. There was history of cataract surgery on left eye in this case
Conclusion : infectious scleritis is often initially diagnosed as autoimmune, and cause diagnostic delay, the aggressive nature of the associated microbes further complicates the situation. Appropriate diagnosis generally includes lession scrapings with thorough culturing and antibiotic sensitivity testing. Both adequate medical and surgical methods are needed to save the globe from loss
OCULAR INVOLVEMENT IN SNAKEBITE PATIENT: A CASE TO REMEMBER
Authors: Novianti  , Elisa Yopitasari  
Published: February 2024

Introduction : Snake bite cases in Indonesia are not rare with mild to catastrophic consequences on the bitten subject due to its hemolytic and neurotoxic effects. This case represents a rare ocular neurotoxic effect of snake’s venom that cause binocular diplopia and ptosis in a child.
Case Illustration : A 9 year-old boy was consulted to ophthalmologist with chief complaint of binocular diplopia. He was hospitalized after being bitten by a snake on his right hand and had an episode of delirious state. Ophthalmologic examination revealed ptosis and exotropia of his left eye in primary position. Further examination of anterior and posterior segments showed good results. His visual acuity was unaffected. Intravenous antivenom was administered and the bite wound was taken care. The boy was discharged from the hospital with a good general condition but still an opthalmoplegia. After a week of follow up the diplopia diminished and his ocular motility was recovered.
Discussion : Ocular manifestations in snake bite case might be missed because of delirious state of the patients. Snake venom can cause ptosis and ophthalmoplegia (neurotoxic) along with uveitis, optic neuritis, central retinal artery occlusion or vitreous and retina hemorrhage due to its hemolytic effect. Time interval between the bite and treatment is one of crucial factor that indicate the patient’s prognosis.
Conclusion : Thorough examination of anterior to posterior ocular segments is needed in every snake bitten patients to rule out any further ocular complication. An early administration of intravenous antivenom is still a mandatory.
Temporary Partial Periosteal Graft for Emergency Management in Peripheral Corneal Perforation
Authors: Indah Saraswati  , Ridho Ranovian  , Yulia Aziza  , Astrianda Nadya Suryono  
Published: February 2024

Introduction : Corneal perforation occurs secondary to a number of corneal abnormalities and leads to further complications if left untreated. Varies options for managing corneal perforation had been conducted, yet the data of periosteal graft in ophthalmology was still limited. This case report aims to evaluate the efficacy of periosteal graft in peripheral corneal perforation.
Case Illustration : A 77-year-old female patient came with a chief complain 14-day history of severe ocular pain and blurry vision of left eye. Initially, there were recurrent ocular redness with foreign body sensation since 6 month before admission, yet denied any history of systemic and autoimmune diseases. She was assessed as corneal infection by some hospitals and treated with some medications, yet the symptoms were not improved. The ophthalmological examination revealed a 360 degrees corneal thinning with uveal prolapse on the infero-temporal on limbus part. The perforation was treated with partial periosteal graft and conjunctival resection, as the corneal donor for tectonic keratoplasty was not available. A few months after surgery, the grafts remained in place after the surgery, even though the visual acuity was still the same.
Discussion : Because of its ease in harvesting, avascularity, strength and lack of immune reaction, autogenous periosteum is a potential grafting tissue for corneal covering in the case of corneal perforation, although it was not the gold standard treatment. This technique presented satisfactory results with low complication rates and minimum number of complications.
Conclusion : Temporary partial periosteal graft could be considered as emergency surgical options in peripheral corneal perforation.
A Rare Embryological Phenomenon: Kissing Nevus Incidence and Clinical Features
Authors: Atika syafendra  , Mardijas efendi  , Hendrianti  
Published: February 2024

Introduction & Objectives : Kissing nevus is a condition where the nevus extends up to the lid margins, its edges touch or “kiss” when the eyelids are closed. Although commonly presenting at birth, there have been cases where it appeared in later life. This occurs due to a rare embryological phenomenon and thus only 30 cases have been reported worldwide until 2020. Meanwhile in M Djamil Hospital Padang we found 4 cases during 2020-2022. This paper is aim to present this so called rare cases in a modest way
Methods : This is a descriptive study related to kissing nevus cases in M Djamil Hospital Padang during 2020-2022. We diagnosed it clinically based on ophthalmology examination. The data were collected into master table and being analyzed. We put patient’s identity (name, age, and gender), nevus location, size, gross anatomy of the nevus and surgical procedure
Results : Four patients were discussed in this study. Most of the patients (75%) is a woman. We found more cases in the first 2 decades of life (50%). The predilection location is at the temporal eyelid (50%), it’s size is equal, both (10-19 mm and 20-29 mm) is 50%. In study we only found a melanotic lesion (100%). Most of the patient were treated with excision biopsy + skin flap (75%)
Conclusion : The prevalence of kissing nevus in M Djamil Hospital is high. Kissing nevus mostly suffered by young women, most cases affected temporal eyelid, the size 10-29 mm so that skin flap is the most suitable surgical procedure