bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epigenetic Regulation of Leukocyte Inflammatory Mediator Production Dictates Staphylococcus aureus Craniotomy Infection Outcome
Authors: Van Roy Zachary , Shi Wen , Kak Gunjan , Duan Bin , Kielian Tammy 
Published: June 2023

Abstract
Staphylococcus aureus is a common cause of surgical-site infections, including those arising after craniotomy, which is performed to access the brain for the treatment of tumors, epilepsy, or hemorrhage. Craniotomy infection is characterized by complex spatial and temporal dynamics of leukocyte recruitment and microglial activation. We recently identified unique transcriptional profiles of these immune populations during S. aureus craniotomy infection. Epigenetic processes allow rapid and reversible control over gene transcription; however, little is known about how epigenetic pathways influence immunity to live S. aureus. An epigenetic compound library screen identified bromodomain and extraterminal domain–containing (BET) proteins and histone deacetylases (HDACs) as critical for regulating TNF, IL-6, IL-10, and CCL2 production by primary mouse microglia, macrophages, neutrophils, and granulocytic myeloid-derived suppressor cells in response to live S. aureus. Class I HDACs (c1HDACs) were increased in these cell types in vitro and in vivo during acute disease in a mouse model of S. aureus craniotomy infection. However, substantial reductions in c1HDACs were observed during chronic infection, highlighting temporal regulation and the importance of the tissue microenvironment for dictating c1HDAC expression. Microparticle delivery of HDAC and BET inhibitors in vivo caused widespread decreases in inflammatory mediator production, which significantly increased bacterial burden in the brain, galea, and bone flap. These findings identify histone acetylation as an important mechanism for regulating cytokine and chemokine production across diverse immune cell lineages that is critical for bacterial containment. Accordingly, aberrant epigenetic regulation may be important for promoting S. aureus persistence during craniotomy infection.
Just as the virus can mutate, so can coronavirus disease 2019-related bone necrosis!
Authors: Hamed Hany , Gawish Hesham M 
Published: June 2023

Abstract

Background
The pandemic of COVID-19 virus had led to another pandemic of avascular necrosis.

Aim
To evaluate the altered clinical and radiological presentation of COVID-19-related AVN of the hip.

Methods
This study included 42 patients with AVN of the head of the femur who were presented to the outpatient clinic of Kafr El Sheikh University Hospital. Patients were classified into three main groups. The first group included patients who had COVID infection and received steroid therapy for their pulmonary manifestations. The second group included patients who had COVID infection without receiving steroid therapy. The final group included patients who had AVN of the hip after receiving COVID vaccination without taking any steroid therapy.

Results
The study included 42 patients who had AVN related to COVID-19 infection. Patients who had COVID-19 infection were more susceptible to AVN development at (a) lower threshold dose of steroid (900 g) and (b) earlier onset of presentation (less than a month).

Conclusions
To conclude, there is a silent epidemic of cases presenting daily in our clinics with COVID-19-related AVN.
End-tidal carbon dioxide’s change to fluid challenge versus internal jugular vein dispensability index for predicting fluid responsiveness in septic patients: A prospective, observational study
Authors: Elnakera Abeer M. , Abdullah Radwa M. , Matar Heba M. 
Published: June 2023

Background and Aims:
The prediction of fluid responsiveness is crucial for the fluid management of septic shock patients. This prospective, observational study was conducted to compare end-tidal carbon dioxide (ETCO2) change due to fluid challenge (FC-induced ΔETCO2) versus internal jugular vein distensibility index (IJVDI) as predictors of fluid responsiveness in such patients.

Methods:
Septic hypoperfused mechanically ventilated patients were classified as fluid responders (Rs) and non-responders (NRs) according to the improvement of left ventricular outflow tract-velocity time integral (ΔLVOT-VTI) after fluid challenge (FC). The receiver operating characteristic (ROC) curves of FC-induced ΔETCO2, pre-(FC) IJVDI and their combination for prediction of fluid responsiveness were compared to that of ΔLVOT-VTI% as a gold standard.

Results:
Of 140 patients who completed the study, 51 (36.4%) patients were classified as Rs and 89 (63.6%) patients as NRs. With regard to the prediction of fluid responsiveness, no significant difference (P. 0. 384) was found between the diagnostic accuracy of FC-induced ΔETCO2 >2 mmHg (area under the ROC curve [AUC] 0.908, P < 0.001) and that of pre-(FC) IJVDI >18% (AUC 0.938, P < 0.001), but a prediction model combining both markers, ΔETCO2 ≥3 mmHg and IJVDI ≥16%, achieved significantly higher accuracy (AUC 0.982, P < 0.001) than each independent one (P < 0.05).

Conclusion:
Under stable ventilatory and metabolic conditions, the predictivity of FC-induced ΔETCO2 >2 mmHg can be comparable to that of pre-(FC) IJVDI >18%. A predictive model combining both FC-induced ΔETCO2 ≥3 mmHg and IJVDI ≥16% can provide higher accuracy than that recorded for each one independently.
Implication of photic sneeze reflex in ophthalmology
Authors: Shetty Pooja A. , Bhat Shruti , Jain Vikram , Girish Shibin , Shetty Harish , Kudlu Krishna P. 
Published: June 2023

Background:
Photic sneeze reflex (PSR) also known as autosomal dominant compelling helioophthalmic outburst is a rare condition characterized by uncontrolled sneezing in response to bright light. The exact mechanism causing this is poorly understood. However, various hypotheses have been proposed. Ophthalmic examination involves exposing the patient to bright light like slit lamp, indirect ophthalmoscopy, and surgical microscope, which can trigger sneezing in PSR patients.

Purpose:
The purpose of this video is to draw light to this rare phenomenon and its implication in ophthalmic surgery

Synopsis:
A 74-year-old male patient presented with diminution of vision in left eye. On routine slit lamp and IDO examination, patient had repeated sneezing. We diagnosed him to have photic sneeze reflex. He had pseudophakic bullous keratopathy in the right eye and senile immature cataract in the left eye. Taking into consideration his one eyed status and PSR, measures were taken accordingly and cataract surgery was performed uneventfully. We describe in this video the challenges encountered with this phenomenon and approach in such cases.

Highlights:
In this video, we tried to give an idea about photic sneeze reflex and its theories. Also, we tried to bring out the impact of PSR on ophthalmologic practice

Video link:
https://youtu.be/KMZ_PC0hzhI

Key words: Photic sneeze reflex, slitlamp light, sneeze
Retinal laser – Protocols and practical tips
Authors: Ratra Dhanashree , Nag Adwaita , Sharma Hitesh 
Published: June 2023

Background:
Many a young doctors in training find retinal laser photocoagulation a daunting task. However, if correct protocols are followed and checklists are observed, then it is not difficult to have a successful laser sitting with a happy patient. Most of the complications can be avoided with correct settings and techniques.

Purpose:
To enumerate the basic protocols of retinal laser photocoagulation and provide practical tips including laser settings and checklists for hassle-free laser experience.

Synopsis:
Laser settings for a pan-retinal photocoagulation (PRP) for proliferative diabetic retinopathy differ from those for a focal laser for macular edema. A fill in PRP is indicated when an active Proliferative diabetic retinopathy (PDR) is seen after the initial PRP is completed. The settings and protocols for laser photocoagulation for lattice degeneration are different, and various techniques of barrage laser are discussed. Practical tips and checklists are given, which will not be found in any textbooks.

Highlights:
Animated illustrations and fundus photos are used to explain the correct techniques of performing laser photocoagulation in different indications and scenarios. Detailed instructions and checklists are provided, which can be very useful to avoid complications and medicolegal problems. The practical tips and guidelines in an easy-to-understand manner make this video highly educational for the novice retinal surgeons who want to perfect their technique of retinal laser photocoagulation.

Video Link:
https://youtu.be/saQ4s49ciXI

Key words: Diabetic macular edema, focal laser, lattice barrage laser, panretinal photocoagulation, proliferative diabetic retinopathy, practical tips, retinal laser
Outcomes of lensectomy with glued intraocular lens and factors associated with failure in eyes with spherophakia and glaucoma
Authors: Burugupally Keerthi , Senthil Sirisha , Parameshwarappa Deepika C , Ali Hasnat , Balakrishnan Divya , Garudadri Chandrasekhar 
Published: June 2023

Purpose:
To evaluate the outcomes of lensectomy with a glued intraocular lens (IOL) in spherophakic eyes with secondary glaucoma and assess factors associated with failure.

Methods:
We prospectively evaluated outcomes of lensectomy with glued IOL in 19 eyes with spherophakia and secondary glaucoma (intraocular pressure (IOP) ≥22 mm Hg and/or glaucomatous optic disc damage) between 2016 and 2018. The vision, refractive error, IOP, antiglaucoma medications (AGMs), optic disc changes, need for glaucoma surgery, and complications were assessed. Success was defined as complete when IOP was ≥5 and ≤21 mmHg without AGMs; qualified success as similar IOP with up to 3 AGM; the need for >3AGM/additional surgery for IOP control was considered a failure.

Results:
Preoperatively, the median (interquartile range: IQR) age was 18 (13.5–30) years. IOP was 16 (14–22.5) mmHg on a median of 3 (2,3) AGMs. Median postoperative follow up was 27.7 months (11.9, 39.7). Postsurgery, most patients achieved emmetropia, with significantly decreased refractive error from a median spherical equivalent of −12.5D to + 0.5D, P < 0.0002. The complete success probability was 47% (95% confidence intervals (CIs): 29–76%) at 3 months and was 21% (8 − 50%) at 1 year and 3 years. The qualified success probability was 93% (82–100%) at 1 year, which reduced to 79% (60–100%) in 3 years. None of the eyes had any retinal complications. The higher number of preoperative AGM was found to be a significant risk factor (p < 0.02) for the failure of complete success.

Conclusion:
One-third of the eyes had IOP control without the need for AGM postlensectomy with glued IOL. Surgery resulted in significant improvement in visual acuity. The higher number of preoperative AGM was associated with poor glaucoma control after glued IOL surgery.
Microbial keratitis and antibiotic sensitivity patterns: A retrospective analysis at a tertiary center in Central India
Authors: Parmar Gautam Singh , Meena Ashok Kumar , Borde Prashant , Prasad Sonali 
Published: June 2023

Purpose:
To report on the microbiological profile and antibiotic sensitivity patterns of infectious keratitis at a tertiary center in central India.

Methods:
The suspected case of severe keratitis underwent microbiological culture and identification using the VITEK 2 technique. Antibiotic susceptibility for different sensitivity and resistance patterns was analyzed. Demographics, clinical profile, and socioeconomic history was also documented.

Results:
Culture was positive in 233/455 (51.2%) patients. Pure bacterial growth was present in 83 (35.62%) patients and pure fungus was present in 146 (62.66%) patients. The most common bacterial cause of infectious keratitis was Pseudomonas followed by Staphylococcus and Bacillus. Pseudomonas showed 65%–75% resistance against levofloxacin, ceftazidime, imipenem, gentamycin, ciprofloxacin, and amikacin. Staphylococcus showed 65%–70% resistance against levofloxacin, erythromycin, and ciprofloxacin, with Streptococcus being 100% resistant to erythromycin.

Conclusion:
This study highlights the current trend of microbiological profiles of infectious keratitis and their antibiotic susceptibility at a rural setup in central India. Fungal predominance and increased resistance against the commonly used antibiotics were noted.
Surgical decisions and outcomes of rhegmatogenous retinal detachment during the coronavirus disease 2019 pandemic: Data from a tertiary referral center in Taiwan
Authors: Wu Po-Yi , Chou Hung-Da , Hwang Yih-Shiou , Kang Eugene Yu-Chuan , Chen Yi-Hsing , Liu Laura , Chen Kuan-Jen , Wu Wei-Chi , Chen Hung-Chi 
Published: June 2023

Purpose:
To assess changes in surgical decisions and outcomes of rhegmatogenous retinal detachment (RRD) during the COVID-19 pandemic at a tertiary center in Taiwan.

Methods:
Patients undergoing pars plana vitrectomy (PPV) or scleral buckling (SB) for primary RRD during Taiwan’s first wave of domestic COVID-19 cases surge between May and July 2021 (COVID cohort, n = 100) were compared to controls in the closest pre-COVID year, 2019 (pre-COVID cohort, n = 121).

Results:
The COVID cohort had significantly worse RRD presentation, received more PPV (alone or combined with SB (PPV + SB)) and less SB alone, and had comparable single-surgery anatomic success (SSAS) rates. In patients who underwent PPV, more underwent PPV + SB instead of PPV alone. The decision to combine SB in PPV surgery was significantly affected by the COVID pandemic (odds ratio [OR], 3.1860 [95% confidence interval (CI), 1.1487–8.8361]). However, a shorter duration of symptoms before the first presentation (0.9857 [95% CI, 0.9720–0.9997]) was the only factor related to SSAS, whereas the surgical method had no association. The SSAS rate remained close to or over 90% in patients with a duration of symptoms before surgery ≤4 weeks but dropped to 83.3% in patients with duration >4 weeks.

Conclusion:
During the COVID-19 pandemic, worse RRD presentations led to a shift in preference for PPV over SB alone as the primary surgery. The pandemic affected surgeons’ decision to combine SB during PPV. Nevertheless, SSAS was only associated with the duration of symptoms but not with surgical methods.
A study establishing sensitivity and accuracy of smartphone photography in ophthalmologic community outreach programs: Review of a smart eye camera
Authors: Andhare Pooja , Ramasamy Kim , Ramesh Rahul , Shimizu Eisuke , Nakayama Shintaro , Gandhi Preethika 
Published: June 2023

Purpose:
Diseases affecting the cornea are a major cause of corneal blindness globally. The pressing issue we are facing today is the lack of diagnostic devices in rural areas to diagnose these conditions. The aim of the study is to establish sensitivity and accuracy of smartphone photography using a smart eye camera (SEC) in ophthalmologic community outreach programs.

Methods:
In this pilot study, a prospective non-randomized comparative analysis of inter-observer variability of anterior segment imaging recorded using an SEC was performed. Consecutive 100 patients with corneal pathologies, who visited the cornea specialty outpatient clinic, were enrolled. They were examined with a conventional non-portable slit lamp by a cornea consultant, and the diagnoses were recorded. This was compared with the diagnoses made by two other consultants based on SEC videos of the anterior segment of the same 100 patients. The accuracy of SEC was accessed using sensitivity, specificity, PPV, and NPV. Kappa statistics was used to find the agreement between two consultants by using STATA 17.0 (Texas, USA).

Results:
There was agreement between the two consultants to diagnosing by using SEC. Above 90% agreements were found in all the diagnoses, which were statistically significant (P-value < 0.001). More than 90% sensitivity and a negative predictive value were found.

Conclusion:
SEC can be used successfully in the community outreach programs like field visits, eye camps, teleophthalmology, and community centers, where either a clinical setup is lacking or ophthalmologists are not available.
Outcomes of preloaded toric intraocular lens implantation in eyes undergoing phacoemulsification
Authors: Nagpal Ritu , Shakkarwal Chetan , Ahsan Saima , Maharana Prafulla Kumar , Goel Madhav , Sharma Namrata 
Published: June 2023

Purpose:
To evaluate the clinical outcomes of preloaded toric intraocular lens (IOLs) implantation in eyes undergoing phacoemulsification.

Methods:
This prospective study included 51 eyes of 51 patients with visually significant cataracts and corneal astigmatism ranging between 0.75 and 5.50 D. All patients underwent phacoemulsification with SupraPhob toric intraocular lens implantation under topical anesthesia. The main outcome measures were uncorrected distance visual acuity (UDVA), residual refractive cylinder, spherical equivalent, and IOL stability at 3 months follow-up.

Results:
At 3 months, 49% (25/51) of patients had UDVA equal to or better than 20/25 with 100% of eyes achieving better than 20/40. Mean logMAR UDVA improved from 1.02 ± 0.39, preoperatively to 0.11 ± 0.10 at 3 months follow-up (P < 0.001, Wilcoxon signed-rank test). The mean refractive cylinder improved from − 1.56 ± 1.25 D preoperatively to − 0.12 ± 0.31 D at 3 months follow-up (P < 0.001) while the mean spherical equivalent value changed from − 1.93 ± 3.71D preoperatively to − 0.16 ± 0.27D (P = 0.0013). The mean root mean square value for higher order aberrations was 0.30 ± 0.18 μm while the average contrast sensitivity value (Pelli-Robson chart) was 1.56 ± 0.10 log unit, at the final follow-up. The mean IOL rotation at 3 weeks was 1.7 ± 1.61 degrees, which did not change significantly at 3 months (P = 0.988) follow-up. There were no intraoperative or postoperative complications.

Conclusion:
SupraPhob toric IOL implantation is an effective method for addressing preexisting corneal astigmatism in eyes undergoing phacoemulsification with good rotational stability.
Outcomes of 8 × 8 mm osteotomy in powered external dacryocystorhinostomy
Authors: Goel Ruchi , Ojha Sweta , Gaonker Tanvi , Shah Shalin , Meher Ravi , Arya Deepanjali , Khanam Samreen , Kumar Sushil 
Published: June 2023

Purpose:
To study the endoscopic ostium characteristics and outcome of 8 × 8 mm osteotomy in external dacryocystorhinostomy (DCR) using the microdrill system.

Methods:
This prospective interventional pilot study was performed on 40 eyes of 40 patients with primary acquired nasolacrimal duct obstruction (NLDO) from June 2021 to September 2021 in patients undergoing external DCR. An 8 × 8 mm osteotomy was performed using round, cutting burr attached to a microdrill system. Success was defined as patent ostium on lacrimal syringing (anatomical) and a Munk score <3 (functional) at 12 months. Postoperative endoscopic ostium evaluation was done using a modified DCR ostium (DOS) scoring system at 12 months.

Results:
The mean age of the study participants was 42.41 ± 11.77 years and the male-to-female ratio was 1:4. The mean duration of surgery was 34.15 ± 1.66 minutes and that for osteotomy creation was 2.5 ± 0.69 minutes. The mean intraoperative blood loss was 83.37 ± 11.89 ml. Anatomical and functional success rates were 95% and 85%, respectively. The mean modified DOS score was “excellent” in 34 patients (85%), “good” in 1 patient (2.5%), “fair” in 4 patients (10%), and “poor” in 1 patient (2.5%). Complications included nasal mucosal injury in 10% (4/40) of patients, complete cicatricial closure of ostium in 2.5% (1/40), incomplete cicatricial closure in 10% (4/40), nasal synechiae in 5% (2/40), and canalicular stenosis in 2.5% (1/40).

Conclusion:
An 8 × 8 mm–sized osteotomy created by powered drill and covered by lacrimal sac–nasal mucosal flap anastomosis in external DCR is an effective technique that has minimal complications and shorter surgical time.
Biểu đồ tim thai loại II trong chuyển dạ: kết cục thai kỳ và mô hình dự đoán trẻ ngạt
Authors: Nguyễn Thị Cẩm Nhung , Trịnh Trần Xuân Vinh , Nguyễn Thị Yến , Lê Quang Thanh , Nguyễn Hồng Hoa 
Published: June 2023

Đặt vấn đề: Biểu đồ tim thai (CTG) loại II theo tiêu chuẩn ACOG là loại thường gặp nhất trên lâm sàng nhưng lại không đặc hiệu cho tình trạng thiếu oxy thai. Nghiên cứu đánh giá kết cục thai kỳ khi CTG loại II, từ đó, khảo sát các yếu tố liên quan đến trẻ ngạt trên đối tượng CTG loại II nhằm nâng cao giá trị dự đoán của CTG loại II, để đạt được mức cân bằng tốt nhất giữa dự hậu sơ sinh tốt và giảm tối đa những can thiệp phẫu thuật không cần thiết.
Mục tiêu nghiên cứu: Xác định tỷ lệ trẻ ngạt, tỷ lệ mổ lấy thai và khảo sát các yếu tố liên quan từ đó xây dựng mô hình dự đoán trẻ ngạt (Apgar 5 phút < 7).
Đối tượng và phương pháp nghiên cứu: Sản phụ vào chuyển dạ có biểu đồ tim thai loại II tại Khoa Sanh - Bệnh viện Từ Dũ, theo dõi kết cục đến lúc sinh. Nghiên cứu mô tả dọc tiến cứu. Đánh giá trẻ ngạt bằng bảng điểm Apgar 5 phút < 7.
Kết quả: Nghiên cứu 960 CTG loại II ghi nhận kết cục trẻ ngạt chiếm tỷ lệ 1,9% KTC 95% (1,0% - 2,7%). Tỷ lệ mổ lấy thai trong chuyển dạ là 50,4%. Xây dựng mô hình dự đoán trẻ ngạt gồm 10 yếu tố: tuổi mẹ, BMI trước mang thai, tiền căn mổ lấy thai, đái tháo đường thai kỳ, thai chậm tăng trưởng trong tử cung, dây rốn quấn cổ thai, gò cường tính, màu sắc nước ối, nhịp giảm muộn và nhịp giảm kéo dài trên CTG. Diện tích dưới đường cong ROC của mô hình là 0,874.
Kết luận: Tỷ lệ trẻ ngạt 1,9%, tỷ lệ mổ lấy thai 50,4% trường hợp CTG loại II. Biểu đồ tim thai loại II đơn thuần không phản ánh hoàn toàn tình trạng suy thai. Mô hình dự đoán trẻ ngạt là sự kết hợp biểu đồ tim thai với bối cảnh lâm sàng cụ thể nhằm nâng cao giá trị chẩn đoán của công cụ này.
Diagnostico para el diseño del manual administrativo de contenido multiple para el gobierno municipal de Tzimol, Chiapas
Authors: Chávez Luis Magín Gómez , Zúñiga José Antonio Aranda , Lessieur Caralampio Faustino Culebro , Lessieur Guadalupe del Carmen Culebro 
Published: June 2023

Los manuales administrativos constituyen un medio de comunicación en las organizaciones, fortaleciendo al recurso humano para la realización de sus actividades y generando efectividad, productividad y calidad en las mismas. Es por ello que el Instituto Nacional para el Federalismo y Desarrollo Municipal en su programa “Agenda para el Desarrollo Municipal” trata de fortalecer a los gobiernos municipales, con dichos manuales, para que se conviertan en una administración pública municipal de calidad y al considerarse como el gobierno más cercano a la población se convierte en una obligación, señalada en la Ley de Transparencia y Acceso a la Información Pública del Estado de Chiapas, el publicarlos en los portales de transparencia.
UJI RESISTENSI KLON-KLON INTRODUKSI TERHADAP PENYAKIT GUGUR DAUN Pestalotiopsis sp. DI LABORATORIUM
Authors: Didi Kusnedy  , Eka Bobby Febrianto  , Sayurandi  , Cici Indriani Dalimunthe  
Published: June 2023

Tanaman karet (Hevea brasiliensis) berasal dari negara Brazil. Pohon karet pertama kali hanya tumbuh di Amerika Selatan. Perkebunan karet di Indonesia mulai diperkenalkan sejak tahun 1864, yaitu sejak Hofland mendirikan perusahaan perkebunan karet di Tanah Panunukan dan Ciasem, Jawa Barat. Serangan yang diakibatkan oleh penyakit Pestalotiopsis sp. menunjukkan bercak cokelat pada daun karet dan adanya batas yang jelas antara bagian bercak dengan bagian daun yang masih sehat. Daun yang terinfeksi gugur sebelum waktunya. Umumnya yang terserang berat adalah tanaman karet yang sudah menghasilkan dan tidak terawat. Penelitian bertujuan untuk mengetahuai tingkat resistensi beberapa klon introduksi yaitu PB 217, PB 260, PB 330, PB 340, RRIC 100, IRR 220 dan GT 1 terhadap penyakit gugur daun yaitu Pestalotiopsis sp. Penelitian dilakukan di Laboratorim Proteksi Tanaman Balai Penelitian Sungai Putih menggunakan Rancangan Acak Lengkap (RAL) non faktorial. Hasil penelitian menunjukkan bahwa pada pengamatan 8 hari setelah inokulasi (hsi) intensitas serangan tertinggi ditemukan pada klon PB 217 dan GT 1 yaitu sebesar 89,9%6 dan 89,96%, sedangkan intensitas serangan terendah terdapat pada klon IRR 220 yaitu sebesar 81,64%.