bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of preoperative posturing on subfoveal fluid height in macula-off retinal detachments
Authors: Johannigmann-Malek Navid , Kaye Stephen B , Badawood Shadi , Maier Mathias , Baumann Carmen 
Published: June 2023

Abstract

Purpose:
To evaluate the effect of preoperative posturing on subfoveal fluid height (SFFH) in macula-off retinal detachment (RD)

Methods:
Prospective study including patients with macula-off RD with SFFH measurable on optical coherence tomography (OCT) and duration of loss of central vision (LCV) ≤ 7 days. Linear OCT volume scans were performed at baseline, after one minute, one hour, four hours and on the next morning. For the first hour all patients remained in an upright position. Patients were then either instructed to posture until the surgery according to the location of the primary retinal break (posturing group) or were not given any instructions (control group).

Results:
Twenty-four patients were included in the posturing group and 11 patients in the control group. There was no significant change in SFFH between baseline, 1 minute, 1 hour and 4 hours. Mean SFFH in the control group increased by 243 µm from 624 (±268) µm at baseline to 867 (±303) µm the next morning (p<0.01) but decreased in the posturing group by 150 µm from 728 (±416) to 578 (±445) µm (p=0.03). There was a significant association of the SFFH the next morning with posturing (p<0.01) and SFFH at baseline (p<0.01), but not with location of primary break (p=0.20). The change in SFFH from baseline to the next morning was significantly associated with posturing and primary break location (p<0.01) but not with SFFH at baseline (p=0.21).

Conclusion:
Preoperative posturing is an effective measure to prevent progression of macular detachment in macula-off RD.
MACULAR HOLE IN A PATIENT WITH PENTOSAN POLYSULFATE MACULOPATHY
Authors: Arora Neha , Hoyek Sandra , Patel Nimesh A. 
Published: June 2023

Purpose:
Pentosan polysulfate (PPS), a drug used for interstitial cystitis, has recently been detected to cause maculopathy in a dose-dependent manner. Outer retinal atrophy is the hallmark of this condition.

Methods:
History, examination, and multimodal imaging were used to guide diagnosis and management.

Results:
We report a case of PPS-related maculopathy in a 77-year-old lady, who presented with florid retinal atrophy at the posterior pole in both eyes, and a concurrent macular hole in the left eye. She had been diagnosed with interstitial cystitis several years before for which she was prescribed PPS (Elmiron). She had noticed a drop in vision 5 years after initiation of PPS and self-discontinued the drug after 24 years of use. A diagnosis of PPS-related maculopathy with a macular hole was made. She was counselled regarding the prognosis and was advised to avoid PPS. Surgery for macular hole was deferred in view of the severe retinal atrophy.

Conclusion:
Pentosan polysulfate-related maculopathy can lead to severe retinal atrophy and a subsequent degenerative macular hole. A high index of suspicion is required for early detection and cessation of drug to prevent this irreversible vision loss.
Meningitis Risk in Patients with Inner Ear Malformations after Cochlear Implants: A Systematic Review and Meta-Analysis
Authors: Gowrishankar Shravan , Fleet Alex , Tomasoni Michele , Kuhn Isla , Tysome James , Smith Matthew E. , Donnelly Neil , Axon Patrick , Borsetto Daniele , Bance Manohar 
Published: June 2023

Objective
The objective of this study is to determine the rate of postoperative meningitis after cochlear implantation in those with inner ear malformations (IEMs) via meta-analysis.

Data sources
Medline, EMBASE, and the Cochrane Library.

Methods
This study was reported following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist. Proportion meta-analysis was conducted through an inverse variance random-effect model based on arcsin transformation and presented as forest plots. Quality assessment of the included studies was performed through the National Institutes of Health Quality Assessment Tool.

Results
Overall, 38 of 2966 studies met the inclusion criteria and were included in the analysis. There were 10 cases of meningitis after cochlear implantation in 1300 malformed ears. The overall rate of meningitis after cochlear implantation in IEMs was 0.12% (95% confidence interval, 0.006–0.380%; I
2 = 0%). Cases occurred in incomplete partition (n = 5), Mondini deformity (n = 2), common cavity (n = 2), and enlarged internal auditory canal (n = 1). Six of 10 cases of postoperative meningitis occurred with an intraoperative cerebrospinal fluid leak.

Conclusion
In those with IEMs, the risk of meningitis after cochlear implantation is very low.
Long-Term Hearing Outcomes After Hybrid Cochlear Implantation
Authors: Salmon Mandy K. , Quimby Alexandra E. , Bartellas Michael , Kaufman Hannah S. , Bigelow Douglas C. , Brant Jason A. , Ruckenstein Michael J. 
Published: June 2023

Objective
To examine long-term (>5 yr) low-frequency hearing preservation after hybrid cochlear implantation.

Study Design
Retrospective cross-sectional study.

Setting
Tertiary care center outpatient clinic.

Patients
All patients older than 21 years implanted with a Cochlear Hybrid L24 device from 2014 to 2021.

Main Outcome Measure
Changes in low-frequency pure-tone average (LFPTA) were calculated at each of several time points relative to the date of implantation. The proportion of patients with preserved LFPTA at last follow-up and Kaplan-Meier estimates for loss of residual hearing were calculated in addition to hazard ratios for hearing loss according to patient- and surgery-specific factors.

Results
Thirty ears in 29 patients underwent hybrid cochlear implantation and were eligible for inclusion (mean age, 59 yr; 65% female). Mean preoperative LFPTA was 31.7 dB. Mean LFPTA across all implanted ears at first follow-up was 45.1 dB; no patient had experienced loss of residual hearing at first follow-up. Six patients had loss of residual hearing during the follow-up period, with Kaplan-Meier probability estimates of preserved hearing of 100% at 1 month, 90% at 12 months, 87% at 24 months, and 80% at 48 months. There was no association between loss of residual hearing and patient age, preoperative LFPTA, surgeon, or use of topical steroids intraoperatively (hazard ratios, 1.05 [0.96–1.15], 0.97 [0.88–1.05], 1.39 [0.20–9.46], 0.93 [0.09–9.74], respectively).

Conclusions
Long-term (>5 yr) outcomes after hybrid cochlear implantation demonstrate good preservation of low-frequency hearing, with only modest decline in the long-term postimplantation, and a low proportion of loss of residual low-frequency hearing.
Low-dose naltrexone for treatment of pain in patients with fibromyalgia: a randomized, double-blind, placebo-controlled, crossover study
Authors: Bested Kirsten , Jensen Lotte M. , Andresen Trine , Tarp Grete , Skovbjerg Louise , Johansen Torben S.D. , Schmedes Anne V. , Storgaard Ida K. , Madsen Jonna S. , Werner Mads U. , Bendiksen Anette 
Published: June 2023

Abstract

Introduction:
Fibromyalgia (FM) is a chronic fluctuating, nociplastic pain condition. Naltrexone is a µ-opioid-receptor antagonist; preliminary studies have indicated a pain-relieving effect of low-dose naltrexone (LDN) in patients with FM. The impetus for studying LDN is the assumption of analgesic efficacy and thus reduction of adverse effects seen from conventional pharmacotherapy.

Objectives:

First, to examine if LDN is associated with analgesic efficacy compared with control in the treatment of patients with FM. Second, to ascertain the analgesic efficacy of LDN in an experimental pain model in patients with FM evaluating the competence of the descending inhibitory pathways compared with controls. Third, to examine the pharmacokinetics of LDN.

Methods:
The study used a randomized, double-blind, placebo-controlled, crossover design and had a 3-phase setup. The first phase included baseline assessment and a treatment period (days −3 to 21), the second phase a washout period (days 22–32), and the third phase a baseline assessment followed by a treatment period (days 33–56). Treatment was with either LDN 4.5 mg or an inactive placebo given orally once daily. The primary outcomes were Fibromyalgia Impact Questionnaire revised (FIQR) scores and summed pain intensity ratings (SPIR).

Results:
Fifty-eight patients with FM were randomized. The median difference (IQR) for FIQR scores between LDN and placebo treatment was −1.65 (18.55; effect size = 0.15; P = 0.3). The median difference for SPIR scores was −0.33 (6.33; effect size = 0.13; P = 0.4).

Conclusion:
Outcome data did not indicate any clinically relevant analgesic efficacy of the LDN treatment in patients with FM.
Evaluating the clinical effects of a dynamic shoulder orthosis
Authors: Haarman Claudia J. W. , Hekman Edsko E. G. , van der Kooij Herman , Rietman Johan S. 
Published: June 2023

Background:
Shoulder orthoses reduce the gravitational pull on the shoulder by providing an upward force to the arm, which can decrease shoulder pain caused by stress on the glenohumeral structures.

Objective:
In this interventional study, the clinical effects of a recently developed dynamic shoulder orthosis were assessed in 10 patients with chronic shoulder pain. The shoulder orthosis provides an upward force to the arm with 2 elastic bands. These bands are arranged to statically balance the arm, such that the supportive force is always directed toward the glenohumeral joint and shoulder movements are not impeded.

Study design:
Clinical effect study.

Methods:
The study population was provided with a dynamic shoulder orthosis for 2 weeks. In the week before the orthosis fitting, the participants had no intervention. The primary outcome measures were the mean shoulder pain scores before and during the intervention, and the distance between the humeral head and the acromion without and with orthosis.

Results:
Ultrasound evaluation showed that the shoulder orthosis resulted in a reduction of the distance between the acromion and humeral head at different levels of arm support. In addition, it was demonstrated that the mean shoulder pain scores (range 0–10) decreased from 3.6 to 3 (in rest) and from 5.3 to 4.2 (during activities) after 2 weeks of orthosis use. In general, patients were satisfied with the weight, safety, ease in adjusting, and effectiveness of the orthosis.

Conclusions:
The results of this study show that the orthosis has the potential to reduce shoulder complaints in patients with chronic shoulder pain.
Increased Preoperative Stress Test Utilization is Not Associated With Reduced Adverse Cardiac Events in Current US Surgical Practice
Authors: Columbo Jesse A. , Scali Salvatore T. , Neal Dan , Powell Richard J. , Sarosi George , Crippen Cristina , Huber Thomas S. , Soybel David , Wong Sandra L. , Goodney Philip P. , Upchurch Gilbert R. , Stone David H. 
Published: June 2023

Objective:
To measure the frequency of preoperative stress testing and its association with perioperative cardiac events.

Background:
There is persistent variation in preoperative stress testing across the United States. It remains unclear whether more testing is associated with reduced perioperative cardiac events.

Methods:
We used the Vizient Clinical Data Base to study patients who underwent 1 of 8 elective major surgical procedures (general, vascular, or oncologic) from 2015 to 2019. We grouped centers into quintiles by frequency of stress test use. We computed a modified revised cardiac risk index (mRCRI) score for included patients. Outcomes included in-hospital major adverse cardiac events (MACEs), myocardial infarction (MI), and cost, which we compared across quintiles of stress test use.

Results:
We identified 185,612 patients from 133 centers. The mean age was 61.7 (±14.2) years, 47.5% were female, and 79.4% were White. Stress testing was performed in 9.2% of patients undergoing surgery, and varied from 1.7% at lowest quintile centers, to 22.5% at highest quintile centers, despite similar mRCRI comorbidity scores (mRCRI>1: 15.0% vs 15.8%; P=0.068). In-hospital MACE was less frequent among lowest versus highest quintile centers (8.2% vs 9.4%; P<0.001) despite a 13-fold difference in stress test use. Event rates were similar for MI (0.5% vs 0.5%; P=0.737). Mean added cost for stress testing per 1000 patients who underwent surgery was $26,996 at lowest quintile centers versus $357,300 at highest quintile centers.

Conclusions:
There is substantial variation in preoperative stress testing across the United States despite similar patient risk profiles. Increased testing was not associated with reduced perioperative MACE or MI. These data suggest that more selective stress testing may be an opportunity for cost savings through a reduction of unnecessary tests.
Assessing the Dose-Dependent Effects of tDCS on Neurometabolites using Magnetic Resonance Spectroscopy
Authors: Shinde Anant , Nagarajan Rajakumar , Gunduz Muhammed Enes , Visintainer Paul , Schlaug Gottfried 
Published: June 2023

AbstractConcurrent transcranial direct current stimulation (tDCS) and proton Magnetic Resonance Spectroscopy (1H MRS) experiments have shown up- or downregulation of neurotransmitter concentration. However, effects have been modest applying mostly lower current doses and not all studies found significant effects. Dose of stimulation might be an important variable in eliciting a consistent response. To investigate dose effects of tDCS on neurometabolites, we placed an electrode over the left supraorbital region (with a return electrode over the right mastoid bone) and utilized an MRS voxel (3x3x3cm) that was centered over the anterior cingulate/inferior mesial prefrontal region which is in the path of the current distribution. We conducted 5 epochs of acquisition, each one with a 9:18min acquisition time, and applied tDCS in the third epoch. We observed significant dose and polarity dependent modulation of GABA and to a lesser degree of Glutamine/Glutamate (GLX) with the highest and reliable changes seen with the highest current dose, 5mA (current density 0.39 mA/cm2), during and after the stimulation epoch compared with pre-stimulation baselines. The strong effect on GABA concentration (achieving a mean change of 63% from baseline, more than twice as much as reported with lower doses of stimulation) establishes tDCS-dose as an important parameter in eliciting a regional brain engagement and response. Furthermore, our experimental design in examining tDCS parameters and effects using shorter epochs of acquisitions might constitute a framework to explore the tDCS parameter space further and establish measures of regional engagement by non-invasive brain-stimulation.
Multielectrode Network Stimulation (ME-NETS) demonstrated by concurrent tDCS and fMRI
Authors: Ross David A. , Shinde Anant B. , Lerud Karl D , Schlaug Gottfried 
Published: June 2023

AbstractNon-invasive transcranial direct current stimulation (tDCS) can modulate activity of targeted brain regions. Whether tDCS can reliably and repeatedly modulate intrinsic connectivity of entire brain networks is unclear. We used concurrent tDCS-MRI to investigate the effect of high dose anodal tDCS on resting state connectivity within the Arcuate Fasciculus (AF) network, which spans the temporal, parietal, and frontal lobes and is connected via a structural backbone, the Arcuate Fasciculus (AF) white matter tract. Effects of high-dose tDCS (4mA) delivered via a single electrode placed over one of the AF nodes (single electrode stimulation, SE-S) was compared to the same dose split between multiple electrodes placed over AF-network nodes (multielectrode network stimulation, ME-NETS). While both SE-S and ME-NETS significantly modulated connectivity between AF network nodes (increasing connectivity during stimulation epochs), ME-NETS had a significantly larger and more reliable effect than SE-S. Moreover, comparison with a control network, the Inferior Longitudinal Fasciculus (ILF) network suggested that the effect of ME-NETS on connectivity was specific to the targeted AF-network. This finding was further supported by the results of a seed-to-voxel analysis wherein we found ME-NETS primarily modulated connectivity between AF-network nodes. Finally, an exploratory analysis looking at dynamic connectivity using sliding window correlation found strong and immediate modulation of connectivity during three stimulation epochs within the same imaging session.
Cohort Profile: Born in Wales - a birth cohort with maternity, parental, and child data linkage for life course research in Wales, UK
Authors: Jones HE , Seaborne MJ , Kennedy NL , James ML , Dredge S , Bandyopadhyay A , Battaglia A , Davies S , Brophy S 
Published: June 2023

AbstractPurposeParental and neonatal child health and education records have been linked to provide an entire country birth cohort, to examine what will improve the health and wellbeing of families growing up in Wales. Established in 2020, Born in Wales utilised data linkage techniques to connect information from the 2011 census with health, social care, and education routine data in the Secure Anonymised Information Linkage (SAIL) Databank. We present the descriptive data available in the linked database, emphasise the robust data security and governance frameworks, and present the future expansion plans for the database beyond its initial development stage.ParticipantsDescriptive information from 2011 to 2023 has been gathered from SAIL. This comprehensive dataset comprises over 400,000 child electronic records. To augment this data, the Born in Wales and primary school surveys have contributed quantitative and qualitative responses.Findings to dateThe cohort comprises all children born in Wales since 2011, with follow-up conducted until they finish primary school at age 11. 2,500 parents and 30,000 primary school children have been recruited for enhanced data collection and linkage to the data spine. The child cohort is 51%: 49% female: male, and 6% are from ethnic minority backgrounds. When considering age distribution, 26.8% of children are under the age of 5, while 63.2% fall within the age range of 5-11.Future plansBorn in Wales will expand by 30,000 new births annually in Wales, while including follow-up data of children and parents already in the database. Supplementary datasets complement the existing linkage, including primary care, hospital data, educational attainment and social care. Future research includes exploring the long-term implications of COVID-19 on child health and development, the influence of environmental factors including climate change on health and examining the impact of parental work environment on child health and development.Strengths and limitations of this studyBorn in Wales has established a comprehensive, Wales-wide population-based database which consolidates clinical data from maternity, neonatal, child health, and education records.This national-scale database is supplemented by quantitative and qualitative results from surveys conducted by Born in Wales, providing rich insights into details that cannot be obtained through routinely collected data.The existence of this database enables further data linkage, facilitating life course research on the health and wellbeing of the Wales population.Missing data or errors in routine and administrative data may be constraint.A potential restriction of Born in Wales is the loss of data pertaining to individuals who relocate outside of Wales during pregnancy or after the child’s birth.
Inflammatory profiles are associated with long COVID up to 6 months after illness onset: a prospective cohort study of individuals with mild to critical COVID-19
Authors: Wynberg Elke , Han Alvin X. , van Willigen Hugo D.G. , Verveen Anouk , van Pul Lisa , Maurer Irma , van Leeuwen Ester M. , van den Aardweg Joost G. , de Jong Menno D. , Nieuwkerk Pythia , Prins Maria , Kootstra Neeltje A. , de Bree Godelieve J. 
Published: June 2023

AbstractBackgroundAfter initial COVID-19 disease, immune dysregulation may persist and drive post-acute sequelae of COVID-19 (PASC). We described longitudinal trajectories of cytokines in adults up to 6 months following SARS-CoV-2 infection and explored early predictors of PASC.MethodsRECoVERED is a prospective cohort of individuals with laboratory-confirmed SARS-CoV-2 infection between May 2020 and June 2021 in Amsterdam, the Netherlands. Serum was collected at weeks 4, 12 and 24 of follow-up. Monthly symptom questionnaires were completed from month 2 after illness onset onwards; lung diffusion capacity (DLCO) was tested at 6 months. Cytokine concentrations were analysed by human magnetic Luminex screening assay. We used a linear mixed-effects model to study log-concentrations of cytokines over time, assessing their association with socio-demographic and clinical characteristics that were included in the model as fixed effects.Results186/349 (53%) participants had ≥2 serum samples and were included. Of these, 101 (54%: 45/101[45%] female, median age 55 years [IQR=45-64]) reported PASC at 12 and 24 weeks after illness onset. We included 37 reference samples (17/37[46%] female, median age 49 years [IQR=40-56]). PASC was associated with raised CRP and abnormal diffusion capacity with raised IL10, IL17, IL6, IP10 and TNFα at 24 weeks in the multivariate model. Early (0-4 week) IL-1βand BMI at illness onset were predictive of PASC at 24 weeks.ConclusionsOur findings indicate that immune dysregulation plays an important role in PASC pathogenesis, especially among those individuals with reduced pulmonary function. Early IL-1βshows promise as predictors of PASC.
Not only a matter of age: Machine learning-based characterization of the differential effect of brain stimulation on skill acquisition
Authors: Maceira-Elvira Pablo , Popa Traian , Schmid Anne-Christine , Cadic-Melchior Andéol , Müller Henning , Schaer Roger , Cohen Leonardo G. , Hummel Friedhelm C. 
Published: June 2023

AbstractBrain stimulation shows potential at enhancing cognitive and motor functions in humans. However, multiple studies assessing its effects on behavior show heterogeneous results, especially in healthy older subjects. We propose a new method to predict an individual’s likelihood and the magnitude of the benefit from stimulation, based on the baseline performance of a sequential motor task, framed in the context of their age. Our results show a differential effect of stimulation, in which individuals with less efficient learning mechanisms benefit from stimulation, while those possessing optimal learning strategies resent a detrimental effect. Importantly, this differential effect was determined by one’s ability to integrate task-relevant information at the early stages of training, and not the age. This study paves the way towards the personalized application of stimulation to maximize its effects, and constitutes the first steps to implement an individualized translational clinical intervention, based on the state of the neural system.TeaserAge notwithstanding, brain stimulation is most effective in deficient neural systems, while being detrimental to optimal systemsVisual abstractMain findingAnodal transcranial direct current stimulation (atDCS), applied over the hand representation of the motor cortex concomitant to the training of a sequential motor sequence, has differential effects as a function of the recipient’s ability to integrate task-relevant information at the early stages of training. Stimulation benefits individuals with seemingly less efficient learning mechanisms, enabling the rapid storage of the spatial coordinates of the motor sequence and an accelerated optimization of the accuracy of execution. In contrast, individuals possessing optimal learning mechanisms experience detrimental effects of stimulation, leading to drops in the accuracy of execution.