bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Anterior Segment Optical Coherence Tomography in Staging and Evaluation of Treatment Response in Infectious Keratitis
Authors: Abdelghany Ahmed A. , Alio Jorge L. , AttaAllah Heba Radi 
Published: January 2024

Purpose:
The aim of this study was to evaluate the role of anterior segment optical coherence tomography during follow-up of infectious keratitis and to assess response to treatment.

Methods:
This was a prospective, consecutive, observational clinical series of cases. Twenty-three eyes of 23 patients with clinically proven fungal keratitis were included in the study. The patients received medical treatment according to clinical diagnosis, and follow-up was performed weekly. Slit-lamp examination and photography, and anterior segment optical coherence tomography were performed at initial and follow-up visits until corneal healing occurred. The main outcome measures included infiltrate depth, width, and density; central corneal thickness; minimal corneal thickness; corneal thickness at the site of the lesion; and stromal thickness at the center of the lesion.

Results:
Twenty-three eyes of 23 patients (17 men and 6 women), mean age 42.5 ± 19 (8–66) years, were clinically diagnosed with fungal keratitis. Localization was central in 14 cases and paracentral/peripheral in 9 cases. Healing time was 6 to 12 weeks. Minimal corneal thickness, corneal thickness at the site of lesion, and stromal thickness at the center of lesion, and also infiltrate width and depth changed significantly from the first visit to the healing stage at the last follow-up (0.009, 0.001, 0.007, 0.001, and <0.001, respectively).

Conclusions:
In cases of fungal keratitis, anterior segment optical coherence tomography can provide the clinician with a quantitative assessment of a number of corneal parameters that can be used to determine effectiveness of therapy and confirm complete healing of the lesions that cannot be achieved by clinical evaluation.
Immediate and Delayed Effects of Punctal Plug Insertion on Tear Meniscus Height in Severe Aqueous-Deficient Dry Eye
Authors: Hallali Gabriel , Guindolet Damien , Gabison Eric E. , Cochereau Isabelle , Doan Serge 
Published: January 2024

Purpose:
The aim of this study was to assess the immediate and delayed effects of tear punctal occlusion with punctal plugs on tear meniscus height (TMH) in severe aqueous-deficient dry eye (ADDE) disease.

Methods:
Consecutive patients with severe ADDE related to Sjögren syndrome or ocular graft-versus-host disease underwent inferior and superior occlusion with punctal plugs. TMH was measured using the LacryDiag ocular surface analyzer platform before, 10 minutes, and at least 1 month after punctal occlusion. The corneal fluorescein staining (CFS) score was graded with the Oxford scale (from 0 to 5). Ocular symptoms were graded with a visual analog scale (from 1 to 10).

Results:
We included 24 eyes of 24 patients (mean age 61 ± 9 years; mean follow-up 7 ± 5 months). The mean TMH was 0.19 ± 0.06 mm at baseline and increased significantly to 0.41 ± 0.13 mm (P < 0.001) and 0.46 ± 0.17 mm (P < 0.001) at 10 minutes after punctal plug insertion and at the end of follow-up, respectively. The median CFS score decreased from 3 ± 1 before plug insertion to 1 ± 2 at the end of follow-up (P < 0.001). Many patients (67%; n = 16) reported subjective improvement of symptoms. TMH was negatively correlated with the CFS score and visual analog scale score assessing symptoms.

Conclusions:
Upper and lower punctal occlusion increased TMH in patients with severe ADDE as soon as 10 minutes after plug insertion. TMH remained stable over time, which led to the relief of symptoms and reduced corneal staining.
Using Total Corneal Astigmatism With Femtosecond Laser Cataract Surgery and Arcuate Keratotomy(ies) to Treat Low Amounts of Astigmatism
Authors: Cohen Kenneth L. , Patel Neel K. 
Published: January 2024

Purpose:
The aim of this study was to evaluate outcomes using total corneal astigmatism (TCA) to calculate arcuate keratotomy(ies) (AK) parameters performed with femtosecond laser-assisted cataract surgery to reduce low corneal astigmatism.

Methods:
Patients who had femtosecond laser-assisted cataract surgery and AK with 0.50 diopter (D) to 1.30 D of TCA were included. Exclusion criteria were intraoperative complications, preexisting corneal surgery, and comorbidities that might adversely affect outcomes. Corneal tomography (Galilei G4, Zeimer Ophthalmic Systems AG) was performed preoperatively and 1 month postoperatively. TCA was input into the Donnenfeld limbal relaxing incisions nomogram to calculate the AK parameters. Preoperative and postoperative tomographic and subjective refractive measurements were compared. The Alpins method for vector analysis evaluated results.

Results:
Eighty-two eyes of 82 patients were included. Mean preoperative TCA was significantly reduced from 0.80 ± 0.19 D to 0.51 D ± 0.26 D (P < 0.001). Preoperative posterior corneal astigmatism, −0.28 ± 0.13 D, was unchanged, postoperative posterior corneal astigmatism, −0.28 ± 0.14 D (P = 0.653). Target-induced astigmatism arithmetic mean (0.82 ± 0.21 D) was greater than that of the surgically induced astigmatism (0.70 ± 0.40 D), resulting in an arithmetic mean difference vector of 0.51 ± 0.27 D with a summated mean at 0.16 D at 20 degrees. The correction index was 0.87, indicating undercorrection. Angle of error arithmetic mean, −1.27 ± 23.27 degrees, indicated good alignment.

Conclusions:
Inputting TCA for calculation of femtosecond laser AK parameters can reduce low amounts of preoperative corneal astigmatism, thereby improving uncorrected vision.
Thought Blocking as a Manifestation of Catatonia
Authors: Elmarasi Omar , Abdelhady Safaa , Mahgoub Yassir 
Published: January 2024

Abstract
Catatonia is an underrecognized disorder that has been widely described as a psychomotor syndrome, with little emphasis on its thought and cognitive dimensions. The current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision describes only motor and behavioral presentations, whereas a few catatonia scales describe only one form of thought disorders, which is thought perseveration. Thought blocking, a disorder of the thought process, is characterized by regular interruptions in the thought stream. It was described by several scholars as a sign of schizophrenia, with few reports describing thought blocking in association with catatonia. In this article, we describe the course of a patient with bipolar I disorder who presented with catatonia and demonstrated thought blocking. Her catatonic symptoms and thought blocking improved with the addition of lorazepam, recurred upon lorazepam discontinuation, and improved with resumption of lorazepam, demonstrating a clear on/off phenomenon. This report highlights the importance of recognizing thought and cognitive manifestations of catatonia, as it can enhance recognition and improve treatment.
A component-based analysis of metabolic syndrome's impact on 30-day outcomes after hip fracture: reduced mortality in obese patients
Authors: Singh Aaron , Kotzur Travis , Vivancos-Koopman Irene , Emukah Chimobi , Brady Christina , Martin Case 
Published: January 2024

Abstract

Introduction:
Hip fractures are a common injury associated with significant morbidity and mortality. In the United States, there has been a rapid increase in the prevalence of metabolic syndrome (MetS), a condition comprised several common comorbidities, including obesity, diabetes mellitus, and hypertension, that may worsen perioperative outcomes. This article assesses the impact of MetS and its components on outcomes after hip fracture surgery.

Methods:
Patients who underwent nonelective operative treatment for traumatic hip fractures were identified in the 2015–2020 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Baseline characteristics between groups were compared, and significant differences were included as covariates. Multivariate regression was performed to assess the impact of characteristics of interest on postoperative outcomes. Patients with MetS, or a single one of its constitutive components—hypertension, diabetes, and obesity—were compared with metabolically healthy cohorts.

Results:
In total 95,338 patients were included. Patients with MetS had increased complications (OR 1.509; P < 0.001), but reduced mortality (OR 0.71; P < 0.001). Obesity alone was also associated with increased complications (OR 1.14; P < 0.001) and reduced mortality (OR 0.736; P < 0.001). Both hypertension and diabetes alone increased complications (P < 0.001) but had no impact on mortality. Patients with MetS did, however, have greater odds of adverse discharge (OR 1.516; P < 0.001), extended hospital stays (OR 1.18; P < 0.001), and reoperation (OR 1.297; P = 0.003), but no significant difference in readmission rate.

Conclusion:
Patients with MetS had increased complications but decreased mortality. Our component-based analysis showed had obesity had a similar effect: increased complications but lower mortality. These results may help surgeons preoperatively counsel patients with hip fracture about their postoperative risks.
Interposing Rectus and Gracilis Muscle Flaps for Pelvic Reconstruction in Bladder Exstrophy after Bladder Neck Closure
Authors: Harris Thomas G. W. , Crigger Chad B. , Suresh Visakha , Haffar Ahmad , Sholklapper Tamir N. , Nasr Isam W. , Gearhart John P. , Yang Robin , Redett Richard J. 
Published: January 2024

Background:
The exstrophy-epispadias complex is a spectrum of ventral wall malformations including classic bladder exstrophy and cloacal exstrophy (CE). Patients undergo multiple soft-tissue procedures to achieve urinary continence. If unsuccessful bladder neck closure (BNC) is performed, muscle flaps may be used to reinforce BNC or afterward for fistula reconstruction. In this study, patients reconstructed using a rectus abdominis or gracilis muscle flap were reviewed.

Methods:
A retrospective cohort study of patients with exstrophy-epispadias complex who underwent BNC and had a muscle flap was performed. Indication for flap use; surgical technique; and risks for BNC failure, including mucosal violations (MVs), were reviewed. MVs were previous bladder mucosa manipulation for exstrophy closure, repeat closures, and bladder neck reconstruction. Success was defined as BNC without fistula development.

Results:
Thirty-four patients underwent reconstruction. Indications included fistula prophylaxis during BNC (n = 13), fistula closure after BNC (n = 17), fistula prophylaxis after BNC during open cystolithotomy (n = 1), or fistula closure after open cystolithotomy (n = 3). A vesicourethral fistula developed most frequently in classic bladder exstrophy (88.9%) and vesicoperineal fistula in CE (87.5%). Thirty-three rectus flaps and 3 gracilis flaps were used, with success achieved in 97.1% and 66.7%, respectively. All 34 patients achieved success, and 2 patients with CE required a second flap.

Conclusions:
The rectus flap is preferred as it covers the anteroinferior bladder and pelvic floor to prevent urethral, cutaneous, and perineal fistula formation. The gracilis flap only reaches the pelvic floor to prevent urethral and perineal fistula development. Increased MVs increase the risk of fistula formation and may influence the need for prophylactic flaps.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
A European Multicenter Outcome Study of Perioperative Airway Management Policies following Midface Surgery in Syndromic Craniosynostosis
Authors: Cuperus Iris E. , Mathijssen Irene M. J. , van Veelen Marie-Lise C. , Bouzariouh Anouar , Stubelius Ingrid , Kölby Lars , Lundborg Christopher , Das Sumit , Johnson David , Wall Steven A. , Larysz Dawid F. , Dowgierd Krzysztof , Koszowska Małgorzata , Schulz Matthias , Gratopp Alexander , Thomale Ulrich-Wilhelm , Zafra Vallejo Víctor , Redondo Alamillos Marta , Ferreras Vega Rubén , Apolito Michela , Vergnaud Estelle , Paternoster Giovanna , Khonsari Roman H. ,   Workgroup Craniosynostosis, European Reference Network CRANIO
Published: January 2024

Background:
Perioperative airway management following midface advancements in children with Apert and Crouzon–Pfeiffer syndromes can be challenging, and protocols often differ. This study examined airway management following midface advancements and postoperative respiratory complications.

Methods:
A multicenter, retrospective cohort study was performed to obtain information about the timing of extubation, perioperative airway management, and respiratory complications after monobloc or Le Fort III procedures.

Results:
A total of 275 patients (monobloc surgery, n = 129; Le Fort III surgery, n = 146) were included. Sixty-two patients received immediate extubation and 162 received delayed extubation; 42 had long-term tracheostomies, and 9 had perioperative short-term tracheostomies. In most centers, short-term tracheostomies were reserved for selected cases. Patients with delayed extubation remained intubated for 3 days (interquartile range, 2 to 5 days). The rate of no or only oxygen support after extubation was comparable between immediate and delayed extubation groups (58 of 62 patients [94%] and 137 of 162 patients [85%], respectively). However, the immediate extubation group developed fewer cases of postoperative pneumonia than did the delayed group (0 of 62 [0%] versus 24 of 161 [15%]; P = 0.001). Immediate extubation also appeared safe in moderate to severe obstructive sleep apnea, as 19 of 20 patients (95%) required either no or only oxygen support after extubation. The odds of developing intubation-related complications increased by 21% with every extra day of intubation.

Conclusions:
Immediate extubation following midface advancements was found to be a safe option, as it was not associated with respiratory insufficiency but did lead to fewer complications. Immediate extubation should be considered routine management in patients with no or mild obstructive sleep apnea, and should be the aim in moderate to severe obstructive sleep apnea cases after careful assessment.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Treatment Durability of Limited Fasciectomy versus Percutaneous Needle Fasciotomy for Dupuytren Disease
Authors: van den Berge Bente A. , Omar Fatuma M. A. , Werker Paul M. N. , Zhan Zhuozhao , van den Heuvel Edwin R. , Broekstra Dieuwke C. 
Published: January 2024

Background:
Patients with Dupuytren disease (DD) are mostly surgically treated by percutaneous needle fasciotomy (PNF) or limited fasciectomy (LF), but data on time intervals to retreatment are lacking. The authors aimed to estimate the risk of retreatment within certain time periods after treatment with PNF and LF.

Methods:
The authors used data of participants of a cohort study on the course of DD who were treated only with PNF or LF. The primary outcome measure was time to retreatment of DD. The authors included sex, age at first treatment, and having a first-degree relative with DD as confounders in our analysis. A bivariate gamma frailty model was applied to estimate the risk of retreatment within 1, 3, 5, 10, and 20 years after treatment with PNF and LF.

Results:
The time to retreatment was significantly shorter after treatment with PNF than after LF (Wald test statistic, 7.56; P < 0.001). The estimated 10-year risk of retreatment for men who underwent their first treatment at a younger age and with a first-degree relative with DD was 97% after PNF and 32% after LF. The estimated 10-year risk for women who underwent their first treatment at an older age without a first-degree relative with DD was 20% after PNF and 6% after LF.

Conclusions:
The results show that the patients treated with PNF have a higher risk of retreatment. The results of this study could contribute to individualized information on the treatment durability in the future, which would improve patient counseling about the expected retreatment needs.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Aesthetic Considerations of Simultaneous Reconstruction With Free Flap for Local Advanced Hypopharyngeal Combined With Cervical Esophageal Cancer
Authors: Yang Liu , Li Wen 
Published: January 2024

Background and Objective
Patients with local advanced hypopharyngeal combined with esophageal cancer often require total laryngectomy and cervical esophagectomy, which result in big-sized upper aerodigestive tract defects and neck deformities. Although free flap is widely used to reconstruct aerodigestive defects, the aesthetic results especially that of neck contour have not brought to the forefront or discussed extensively. This article aims to report the preliminary aesthetic results of free flap reconstruction for local advanced hypopharyngeal cancer combined with cervical esophageal cancer defects, highlighting the thickness of subcutaneous fat of the flap.

Methods
A retrospective study of 21 patients with local advanced hypopharyngeal combined with cervical esophageal cancer from July 2010 to August 2022 was conducted. After completing total laryngectomy, bilateral neck dissection, and removal of the tumor with safe margin, a free thigh flap of subcutaneous fat greater than 1 cm in thickness was used to reconstruct the hypopharyngeal and cervical esophageal defects. In addition to general demographic, oncological, and reconstructive data, preoperative and postoperative neck circumferences were recorded and compared. A subjective questionnaire survey was conducted on patients' satisfaction with postoperative neck contour. The patients were followed up from 3 to 10 years, with an average of 3 years.

Results
There were 2 cases (2/21) of free flap loss because of flap necrosis and secondary repair with a pedicled pectoralis major flap. Nineteen flaps (19/21) survived. Three cases (3/21) developed a pharyngeal fistula and one case (1/21) experienced salivary fistula, all of the fistulae healed after drainage and dressing change. There was a relatively high satisfaction rate among patients (16/21) with the postoperative neck contour. A paired sample t test showed no statistically significant difference between the preoperative and postoperative values (t = 2.002, P > 0.05). Patients with a thicker subcutaneous fat flap (≥1.5 cm) had a more symmetrical and fuller neck contour during long-term postoperative follow-up.

Conclusions
The application of a fat-rich subcutaneous free thigh flap to reconstruct the defect of local advanced hypopharyngeal combined with cervical esophageal cancer can achieve better neck aesthetic contour.
Investigating the mechanism of chloroplast singlet oxygen signaling in theArabidopsis thaliana accelerated cell death 2mutant
Authors: Lemke Matthew D. , Abate Alexa N. , Woodson Jesse D. 
Published: January 2024

AbstractAs sessile organisms, plants have evolved complex signaling mechanisms to sense stress and acclimate. This includes the use of reactive oxygen species (ROS) generated during dysfunctional photosynthesis to initiate signaling. One such ROS, singlet oxygen (1O2), can trigger retrograde signaling, chloroplast degradation, and programmed cell death. However, the signaling mechanisms are largely unknown. Several proteins (e.g., PUB4, OXI1, EX1) are proposed to play signaling roles across threeArabidopsis thalianamutants that conditionally accumulate chloroplast1O2(fluorescent in blue light(flu),chlorina 1(ch1), andplastid ferrochelatase 2(fc2)). We previously demonstrated that these mutants reveal at least two chloroplast1O2signaling pathways (represented byfluandfc2/ch1). Here, we test if the1O2-accumulating lesion mimic mutant,accelerated cell death 2(acd2), also utilizes these pathways. Thepub4-6allele delayed lesion formation inacd2and restored photosynthetic efficiency and biomass. Conversely, anoxi1mutation had no measurable effect on these phenotypes.acd2mutants were not sensitive to excess light (EL) stress, yetpub4-6andoxi1both conferred EL tolerance within theacd2background, suggesting that EL-induced1O2signaling pathways are independent from spontaneous lesion formation. Thus,1O2signaling inacd2may represent a third (partially overlapping) pathway to control cellular degradation.
PVRL2 Suppresses Anti-tumor Immunity Through PVRIG- and TIGIT-Independent Pathways
Authors: Yang Jiuling , Wang Li , Byrnes James R. , Kirkemo Lisa L. , Driks Hannah , Belair Cassandra D. , Aguilar Oscar A. , Lanier Lewis L. , Wells James A. , Fong Lawrence , Blelloch Robert 
Published: January 2024

AbstractPVRL2 is believed to act as an immune checkpoint protein in cancer; however, most insight into PVRL2’s role is inferred from studies on its known receptor PVRIG. Here, we directly study PVRL2. PVRL2 levels are high in tumor cells and tumor-derived exosomes. Deletion of PVRL2 in multiple syngeneic mouse models of cancer shows a dramatic reduction in tumor growth that is immune dependent. This effect can be even greater than seen with deletion of PD-L1. PVRL2 functions by suppressing CD8 T and NK cells in the tumor microenvironment. Unexpectedly, the effect of PVRL2 loss on tumor growth remains in the absence of PVRIG. In contrast, PVRIG loss shows no additive effect in the absence of PVRL2. TIGIT blockade combined with PVRL2 deletion results in the greatest reduction in tumor growth. This effect is not recapitulated by the combined deletion of PVRL2 with its paralog PVR, the ligand for TIGIT. These data uncover PVRL2 as a distinct inhibitor of the anti-tumor immune response with functions beyond that of its known receptor PVRIG. Importantly, the data provide a strong rationale for combinatorial targeting of PVRL2 and TIGIT for cancer immunotherapy.
Amphicarpic development in the emerging model organismCardamine chenopodiifolia
Authors: Emonet Aurélia , Pérez-Antón Miguel , Neumann Ulla , Dunemann Sonja , Huettel Bruno , Koller Robert , Hay Angela 
Published: January 2024

SummaryAmphicarpy is an unusual trait where two fruit types develop: one above and the other below ground. This trait is not found in conventional model species, therefore, its development and molecular genetics remain under-studied. Here, we establishCardamine chenopodiifoliaas an emerging experimental system to study amphicarpy.We characterized the development ofC. chenopodiifolia, focusing on differences in morphology and cell wall histochemistry between above- and below-ground fruit. We generated a reference transcriptome using PacBio full-length transcript sequencing (IsoSeq) and used a combination of short and long read sequencing to analyse differential gene expression between above- and below-ground fruit valves.C. chenopodiifoliahas two contrasting modes of seed dispersal. The main shoot fails to bolt and initiates floral primordia that bury underground where they self-pollinate and set seed. By contrast, axillary shoots bolt to position flowers and exploding seed pods above ground. Morphological differences between aerial explosive fruit and subterranean non-explosive fruit were reflected in a large number of differentially regulated genes involved in photosynthesis, secondary cell wall formation and defence responses.Tools established inC. chenopodiifolia, such as a reference transcriptome, draft genome assembly and stable plant transformation, pave the way to explore under-studied traits and discover new biological mechanisms.