bluuebunny/crossref_metadata_2025_split huggingface dataset:
MULTIMODAL RETINAL IMAGING FINDINGS IN HARDIKAR SYNDROME
Authors: Adams Olufemi E. , Adeleye Olufunmilola , Hussein Musse , Naravane Ameay , Looysen Tyler , Simmons Michael A. , Tang Peter H. , Montezuma Sandra R. 
Published: August 2023

Purpose:
To describe the syndromic, clinical, and retinal findings of a patient with an extremely-rare genetic condition known as Hardikar syndrome (HS) with presentation of optical coherence tomography, fundus autofluorescence, fluorescein angiographic, and indocyanine green angiographic findings.

Methods:
Clinical course was detailed and followed over time with examinations and multimodal imaging.

Patient and Results:
A 17-year-old patient with HS was referred for possible retinitis pigmentosa. Dilated fundoscopic examination revealed large, multifocal cauliform patches of chorioretinal retinal pigment epithelium changes with retinal pigment epithelium drop-out involving the macula and periphery in both eyes. Additionally, an inactive choroidal neovascular membrane was present in the left eye. Multimodal imaging with optical coherence tomography, fundus autofluorescence, fluorescein angiography, and indocyanine green angiography correlated with the clinical findings of focal patches of chorioretinal degeneration in both eyes. Additionally, an anomalous finding of the superior retinal arterial vessels filling in tandem with the choroidal was present in the left eye. The patient's clinical findings were consistent with HS, and genetic testing with whole-exome sequencing revealed a pathogenic mutation in the MED12 gene, confirming diagnosis.

Discussion and Conclusions:
Hardikar syndrome is associated with retinal pigment epithelium degeneration, creating focal patches of pigmentary chorioretinal atrophic lesions. Vision loss can occur because of the development of choroidal neovascular membranes. The authors recommend close evaluation and follow-up for HS patients with multimodal retinal imaging.
Linezolid optic neuropathy
Authors: Miller H. Victoria , Cao Angela A. , McClelland Collin M. , Lee Michael S. 
Published: August 2023

Purpose of review
In this article, we reviewed 67 reported cases of linezolid optic neuropathy and describe the common characteristics and expectations for recovery with an emphasis on recent findings in the literature.

Recent findings
Linezolid classically causes a reversible, duration-dependent optic neuropathy. However, in our review, we found only 66.7% of patients recovered complete visual function. Vision loss most commonly affected visual acuity followed by visual field and color vision. We also found patients taking higher doses of linezolid experienced full recovery less often, suggesting a dose-dependent component of linezolid optic neuropathy. Linezolid use has increased in frequency and duration, especially in the treatment of drug-resistant tuberculosis, and data indicate that these patients experience lower rates of complete vision recovery compared with patients taking linezolid for other indications.

Summary
Linezolid is an effective medication for treating drug-resistant infections; however, it may result in optic neuropathy. It is reasonable for patients on linezolid to undergo screening examinations, especially those on higher doses or for prolonged duration of therapy.
Neuro-ophthalmic complications of varicella-zoster virus
Authors: Tofade Toluwalase O. , Chwalisz Bart K. 
Published: August 2023

Purpose of review
This review broadly describes recent neuro-ophthalmic manifestations of varicella-zoster virus (VZV) reported in literature.

Recent findings
Despite varicella vaccination, the incidence of herpes zoster continues to rise, potentially leading to devastating consequences when ocular complications occur.
A small but growing literature documents cases of retinal disease because of varicella reactivation after SARS-CoV-2 vaccination, ischemic optic neuropathy occurring during herpes zoster ophthalmicus, VZV-induced orbital apex syndrome, and immune-mediated ocular complications in patients with prior neuro-ophthalmic manifestations of VZV.

Summary
It is important for clinicians to keep abreast of the diverse neuro-ophthalmic manifestations of VZV as early diagnosis and treatment often lead to better visual outcomes.
Royal College of Ophthalmologists' National Ophthalmology Database study of cataract surgery: report 11, techniques and complications of local anesthesia for cataract surgery in the United Kingdom
Authors: Neo Yan Ning , Gruszka-Goh Marta H. , Braga Alice J. , de Klerk Timothy A. , Lindfield Dan , Nestel Achim , Stewart Stephen , Donachie Paul H.J. , Buchan John C. 
Published: August 2023

Purpose:
To describe variation in local anesthesia techniques and complications over a 10-year period for cataract surgery in the United Kingdom.

Setting:
Reporting centers to the Royal College of Ophthalmologists (RCOphth) National Ophthalmology Database (NOD).

Design:
Retrospective cross-sectional register-based study.

Methods:
Data from the RCOphth NOD were used. Eligible for analysis were 1 195 882 cataract operations performed using local anesthesia between April 1, 2010, and March 31, 2020, in 80 centers.

Results:
Overall, topical anesthesia alone was used in 152 321 operations (12.7%), combined topical and intracameral in 522 849 (43.7%), sub-Tenon in 461 175 (38.6%), and peribulbar/retrobulbar in 59 537 (5.0%). In National Health Service (NHS) institutions, 48.3% of operations were topical with/without intracameral vs 88.7% in independent sector treatment centers (ISTCs). 45.9% were sub-Tenon in NHS vs 9.6% in ISTCs. 5.8% were peribulbar/retrobulbar in NHS vs 1.7% in ISTCs. Anesthetic complication rates decreased from 2.7% in the 2010 NHS year to 1.5% in the 2019 NHS year (overall, 2.1% for NHS; 0.2% for ISTCs). Overall anesthetic complication rates were 0.3%, 0.3%, 3.5%, and 3.1% for topical alone, combined topical/intracameral, sub-Tenon, and peribulbar/retrobulbar, respectively. Complication rates were higher for sharp-needle anesthesia (peribulbar/retrobulbar) in patients taking warfarin rather than direct oral anticoagulants (4.8% vs 3.1%; P = .024). Considerable variation was observed between centers on anesthetic choices and anesthetic complication rates.

Conclusions:
Combined topical and intracameral is the most common choice of anesthesia for cataract surgery in the United Kingdom and is associated with lower anesthetic-related complication rates than sub-Tenon and peribulbar/retrobulbar anesthesia. Variation in the anesthetic choice exists between centers and between NHS and ISTC sectors.
Identification of key pathways and genes involved in psoriasis and vitiligo using bioinformatics analysis
Authors: Zhang Jing-Zhan , Zhang Pan-Pan , Ding Yuan , Li Ting-Ting , Kang Xiao-Jing 
Published: August 2023

Objective:
Psoriasis and vitiligo are common immune-related skin disorders. Patients are often clinically diagnosed with both diseases. However, whether psoriasis and vitiligo share common genetic factors and aberrant signal pathways that predispose patients to both diseases remains unclear. This study was performed to clarify these factors using bioinformatics analysis.

Methods:
Publicly available gene expression profiles for GSE109248 and GSE53552 in psoriasis and GSE75819 and GSE65127 in vitiligo from lesional and non-lesional skin tissues were downloaded from the Gene Expression Omnibus database and analyzed to identify differentially expressed genes (DEGs). Gene Ontology terms analysis, Kyoto Encyclopedia of Genes and Genomes enrichment analysis, and protein–protein interaction analysis was also performed to elucidate the molecular mechanisms.

Results:
Nine overlapping DEGs were found between psoriasis and vitiligo. They are AKR1B10, CRABP1, FOXC1, GPM6B, KIT, MLPH, SOX10, TAGLN, and TUBB2B, respectively. Except for the upregulation of AKR1B10, others are downregulated. Pathway enrichment analyses revealed that these overlapping DEGs were mainly enriched in melanocyte differentiation; exocrine system development; mesenchymal cell development; stem cell differentiation and development; and neural crest cell differentiation, development, and migration. RT-qPCR was used to verify the expression of the DEGs in lesions compared to adjacent non-lesional tissues from three patients with psoriasis combined with vitiligo. Research confirmed that there were statistically significant differences among AKR1B10, FOXC1, KIT, MLPH and SOX10 in lesions compared to adjacent non-lesional tissues (P<0.05), which was consistent with the bioinformatical results.

Conclusion:
In this study, we detected potential genes and their associated enriched pathways to help understand the molecular mechanisms underlying the simultaneous occurrence of psoriasis and vitiligo.
Areal roughness of the dorsal nail plate
Authors: Beatty Brian Lee , Li Edward , Anekwe Adaeze 
Published: August 2023

Objective:
Beau’s lines, onychorrhexis, and psoriatic lesions of the dorsal nail plate may be missed by photographic methods, indicating a need for surface texture measurement methods that are more quantitative, sensitive, and repeatable than visual inspection or imaging. We conducted this study to evaluate the utility of surface texture measurements of cadaveric nails that can be associated with histopathological studies in the future.

Materials:
The nail plates of four cadaveric right pollices and halluces were cleaned and molded, cast in clear epoxy, and scanned with a Sensofar S Neox optical profilometer. A one-way analysis of variance (ANOVA) was performed to determine statistical significance of findings.

Results:
Almost no differences were observed between the pollex and hallux scans, and between the distal and proximal regions. The greatest differences were found between individuals. Although lower magnification (5×) is less sensitive than higher magnification (20×), the lower magnification represented and characterized more of the dorsal nail plate.

Conclusions:
The dorsal nail plate areal roughness has a measurable range of values that may serve as a starting point for evaluating pathological findings, particularly Beau’s lines and psoriatic lesions. The sensitivity of these techniques may be especially valuable in the recognition of less severe states of these diseases that may enable the diagnosis of earlier stages of growth disruptions (Beau’s lines) or psoriasis. Such applications could be especially useful in investigations of the health of wildlife populations or vulnerable human populations with incomplete treatment records.
HIV Syndemic Factor Associations Among Adolescent Gay and Bisexual Men in the Youth Risk Behavior Survey 2015–2019: A Secondary Data Analysis
Authors: Garcia David R. , Fletcher Jason , Goldsamt Lloyd , Bell David L. , Zheng Yaguang , Dunn Navarra Ann-Margaret 
Published: August 2023

Abstract
This analysis of the Youth Risk Behavior Survey examined HIV syndemic factor associations (substance use, violence, mental health, and HIV risk behaviors) among adolescent gay, bisexual, and other men who have sex with men—a population with the highest prevalence of undiagnosed HIV infections. The representative sample (n = 644) exhibited low condom use (52%) and HIV testing (21%). Adjusted multivariate logistic regression models showed that Blacks were less likely to report HIV testing (adjusted odds ratio [aOR] = 0.06, 95% confidence interval [CI] [0.01–0.44], p < .01), whereas Hispanics were more likely to report four or more lifetime sexual partners (aOR = 3.75, 95% CI [1.49–9.44], p < .01), compared with Whites. A syndemic of substance use and intimate partner violence (sexual, sexual dating, and/or physical dating violence) was associated with early intercourse, multiple sexual partners, and drugs/alcohol before intercourse. Multiple syndemic factor exposures were associated with additive risk, suggesting multilevel approaches for HIV prevention.
Helicobacter pylori infection increases the risk of nonalcoholic fatty liver disease: Possible relationship from an updated meta-analysis
Authors: Liu Chenchen , Wu Qian , Ren Ranran , Zhang Zhenyu , Shi Yingjie , Li Hongyun 
Published: August 2023

Background:
The relationship between Helicobacter pylori (H pylori) infection and nonalcoholic fatty liver disease (NAFLD) has long been debated. Although it has been investigated in many observational studies, the results remain controversial. Therefore, we performed an updated meta-analysis to assess the association between H pylori infection and risk of NAFLD by collecting relevant articles.

Methods:
Literature collections were conducted by searching PubMed, EMBASE, Web of Science and Cochrane Library databases. Pooled odds ratios with corresponding 95% confidence intervals were calculated to estimate the strength of the link between H pylori infection and NAFLD using Stata 12.0 software.

Results:
28 studies with 68,047 cases of NAFLD patients and 134,866 controls were finally included in the meta-analysis. Overall, The results suggested a 27.5% increased risk of developing NAFLD in patients with H pylori infection (odds ratios 1.275 95% confidence intervals 1.179–1.379), although significant heterogeneity was observed. There is no significant publication bias observed based on the funnel plot and Begg test. Subgroup analysis revealed that variables of the study design, study region, publication year, and the method of diagnosing H pylori and NAFLD all contribute to the high heterogeneity, while the positive correlation was seen in all subgroup analysis.

Conclusion:
This meta-analysis disclosed 1.275-fold increased risk of the occurrence and development of NAFLD in H pylori (+) group compared with the H pylori (−) group, indicating that H pylori is a serious risk factor in patients susceptible to NAFLD.
Relationship between chronic obstructive pulmonary disease and adiponectin concentrations: An updated meta-analysis and single-cell RNA sequencing
Authors: He Jie , Li Xuemei 
Published: August 2023

Background:
Adipose tissue, being an organ of the endocrine system, can influence the severity of chronic obstructive pulmonary disease (COPD). Even though several inflammatory markers can potentially significantly influence lung function, the precise function of adipokines, like adiponectin, in COPD is still disputed. To analyze the association of COPD with adiponectin concentrations, a meta-analysis of the most recent literature and single-cell sequencing data were conducted.

Methods:
Studies in Embase, PubMed, Cochrane Library, and Web of Science were browsed to obtain relevant data, which were then assessed with the aid of R 4.1.3 and STATA 11.0 software. Standardized mean differences and correlation coefficients aided the analysis of effect values. Moreover, a single-cell sequencing GSE136831 dataset was retrieved to ascertain the mRNA expression of adiponectin gene (ADIPOQ) in the lung tissue of COPD patients to confirm the difference in the expression of adiponectin between the case and control groups.

Results:
This meta-analysis comprised 18 publications involving 24 studies. The overall combined data established the concentration of plasma/serum adiponectin as significantly higher in patients with COPD compared to healthy subjects. Subgroup analyses based on disease status, specimen type, ethnicity, study design method, measurement method, and age of COPD patients demonstrated that all patients with COPD had elevated levels of adiponectin compared to healthy controls. When subgroup analysis was performed for gender alone, the results depicted that male COPD patients had significantly higher adiponectin than healthy males, while female patients of COPD had elevated adiponectin compared to healthy females. Furthermore, it was found that plasma/serum adiponectin appeared to be positively correlated with tumor necrosis factor-α, and it was negatively correlated with FEV1% and FEV1/FVC. The results of single-cell sequencing data suggested that ADIPOQ mRNA was mainly expressed in alveolar epithelial cells, and the level of ADIPOQ mRNA was higher in lung tissues of patients with COPD than in lung tissues of healthy subjects.

Conclusion:
This meta-analysis suggests that the levels of plasma/serum adiponectin are significantly elevated in patients with COPD versus controls. Tumor necrosis factor-α, FEV1/FVC, and FEV1% may all be associated with the concentrations of adiponectin.
A case report of two pelviscopic resections of fibrothecomas originating from the left ovary with recurrence after ten years
Authors: Kim Yun Sook , Lee H.J. 
Published: August 2023

Rationale:
Fibrothecomas are benign ovarians tumors. These are solid sex-cord-stromal tumors, accounting for 1% to 4.7% of all ovarian neoplasms. Their recurrence rate is known to be only 2% following ovarian sparing local mass excision. We report an uncommon case of 2 pelviscopic resections of fibrothecomas originating from the left ovary with recurrence after 10 years in a 34-year-old woman.

Patient concerns:
A 34-year-old married woman was diagnosed with 41 mm sized left ovarian recurrent fibrothecoma. We performed mass excision pelviscopically the first time 10 years ago. She gave birth to her second baby at 7 years after the first surgery. Ten years after the first surgery, fibrothecoma recurred on the same ovary with size larger than before.

Diagnoses:
At the time of its first occurrence 10 years ago, the ultrasound scan revealed a 34 × 23 mm-sized solid hypoechoic mass with well-demarcated margins and minimal Doppler flows. Ultrasound findings at the time of recurrence 10 years later showed the same findings, with its size increased to 41 × 40 mm. Final pathologic findings showed left ovarian fibrothecoma.

Interventions:
After her admission to the hospital, we performed pelviscopic removal of left ovarian fibroma. Microscopic examination revealed predominantly bland spindle cells with collagenous stroma, showing fascicular and storiform growth.

Outcomes:
Surgeries were successful. The patient had been followed-up regularly for 3 years after last surgery. She did not experience any complications. She remained disease-free.

Lessons:
Repetitive local mass excision appears to be an effective surgical option in women of reproductive age. Although there is a sufficient possibility of recurrence several years to decades after only mass excision, mass excision is more appropriate than total oophorectomy in women of childbearing age. Pelviscopic surgery is recommended.
Incorporating a Patient Safety and Quality Course Into the Nursing Curriculum: An Assessment of Student Gains
Authors: Ahmed Fasih Ali , Choudhary Roha Ahmad , Khan Hamza , Ayub Farwa , Hassan Syed Sabih ul , Munir Tahir , Asif Fozia , Ajani Khairulnissa , Jaffer Mehtab , Tharani Zahra , Aboumatar Hanan J. , Haider Adil , Latif Asad 
Published: August 2023

Background
Training nursing students on quality and patient safety (PS) is crucial to ensuring safe healthcare practices given the key role nurses play on the healthcare team. The aim of this study was to evaluate the impact of quality and PS course on the knowledge, and system thinking of students at different stages of the undergraduate nursing course.

Methods
A 4.5-day quality improvement and PS course was conducted at the Aga Khan University School of Nursing and Midwifery for 146 second- and 139 fourth-year students. Students’ knowledge, self-assessment of knowledge and skills, and system thinking were assessed using pretest and posttest.

Results
Of the total of 20 points, the course significantly improved students’ knowledge by a mean of 4.91 points for second-year students (95% confidence interval [CI], 4.32–5.51) and 3.46 points for fourth-year students (95% CI, 2.90–4.02) between pretest and posttest. For systems thinking, the Systems Thinking Scale scores increased by 0.41 points (95% CI, 0.29–0.52) for second-year students and 0.33 points (95% CI, 0.22–0.44) for fourth-year students out of the total of 5 points. The self-assessment scores significantly increased on postcourse assessment for second (P < 0.05) and fourth-year students (P < 0.001). Positive experience reported by students in the narrative reflections complemented these results.

Conclusions
There was a significant increase in nursing students’ knowledge, self-efficacy, and system thinking after participating in this short PS course. Replication at a national level may improve safety knowledge and skills among nursing students with subsequent gains in the safety of healthcare delivery in Pakistan.
Using the Dermal Fat Graft as a Barrier Membrane in Unilateral Alveolar Cleft Grafting: A Randomized Clinical Trial
Authors: El Kassaby Marwa , Abd El Fatah Karim Tarek , Yehia Mahmoud , Gaber Ramy Mohamed , Asar Aseel , El Hadidi Yasser Nabil 
Published: August 2023

Introduction:
Alveolar cleft grafting is a surgical procedure that usually suffers from inferior results.

Methodology:
The patients were divided into 2 groups; study and control. In the study group, the grafted site was covered with a dermal fat graft.

Results:
Showed that the bone fill percentage (Bergland Scale) recorded in the study was significantly better (P=0.03); the study group had 14 successful cases out of 18 compared with the control, which had only 9 out of 20. The study group significantly (P= 0.002) better bone fill (71%±32%) compared with the control (46%±33%). There was a significant reduction in dehiscence in the study compared with the control (P=0.02); the study group had no dehiscence compared with the control, which had 5 dehiscence.

Conclusion:
The dermal fat graft use as a barrier membrane was successful in improving alveolar cleft grafting.
Comparison of phenobarbital monotherapy to a benzodiazepine-based regimen for management of alcohol withdrawal syndrome in trauma patients
Authors: Fleenor Lori Montana , Beavers Jennifer R. , Tidwell William P. , Atchison Leanne , Woo Edward , Medvecz Andrew J. , Beyene Robel T. , Kast Kristopher , Marcovitz David , Dennis Bradley M. , Guillamondegui Oscar D. , Smith Michael C. 
Published: August 2023

BACKGROUND
Alcohol withdrawal syndrome (AWS) is associated with increased morbidity and mortality in the trauma population. Benzodiazepines (BZDs) are standard of care for AWS; however, given the risk of delirium with BZDs and reports of BZD-refractory withdrawal, phenobarbital (PHB) has emerged as an alternative therapy for AWS. Safety and efficacy studies of PHB for AWS in trauma patients are lacking. Our aim was to compare a BZD versus PHB protocol in the management of AWS in trauma patients.

METHODS
We performed a retrospective cohort study at a level 1 trauma center of patients at risk for AWS managed with either a BZD or a low-dose oral PHB regimen. Patients were excluded if they were taking BZDs or barbiturates before admission, received propofol or dexmedetomidine before initiation of the study drug, presented with delirium tremens or seizures, or died or discharged within 24 hours of presentation. The primary outcome was complicated AWS (seizures or alcohol withdrawal delirium/delirium tremens). Secondary outcomes included uncomplicated AWS; therapy escalation; oversedation; delirium-, intensive care unit–, and ventilator-free days; and length of stay.

RESULTS
A total of 411 patients were identified; 118 received BZD, and 293 received PHB. The odds of developing complicated AWS with PHB versus BZD-based therapy were not statistically significant (odds ratio [OR], 0.52; 95% confidence interval [CI], 0.21–1.39); however, patients receiving PHB were less likely to develop uncomplicated AWS (OR, 0.08; 95% CI, 0.04–0.14) and less likely to require escalation of therapy (OR, 0.45; 95% CI, 0.24–0.84). The PHB group had a length of stay 3.1 days shorter than the BZD group (p = 0.002). There was no difference in intensive care unit–, ventilator-, or delirium-free days.

CONCLUSION
A PHB-based protocol for the management of AWS is a safe and effective alternative to BZD-based regimens in trauma patients.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level IV.