bluuebunny/crossref_metadata_2025_split huggingface dataset:
Indoleamine 2,3-Dioxygenase Deletion to Modulate Kynurenine Pathway and to Prevent Brain Injury after Cardiac Arrest in Mice
Authors: Magliocca Aurora , Perego Carlo , Motta Francesca , Merigo Giulia , Micotti Edoardo , Olivari Davide , Fumagalli Francesca , Lucchetti Jacopo , Gobbi Marco , Mandelli Alessandra , Furlan Roberto , Skrifvars Markus B. , Latini Roberto , Bellani Giacomo , Ichinose Fumito , Ristagno Giuseppe 
Published: July 2023

Background
The catabolism of the essential amino acid tryptophan to kynurenine is emerging as a potential key pathway involved in post–cardiac arrest brain injury. The aim of this study was to evaluate the effects of the modulation of kynurenine pathway on cardiac arrest outcome through genetic deletion of the rate-limiting enzyme of the pathway, indoleamine 2,3-dioxygenase.

Methods
Wild-type and indoleamine 2,3-dioxygenase–deleted (IDO−/−) mice were subjected to 8-min cardiac arrest. Survival, neurologic outcome, and locomotor activity were evaluated after resuscitation. Brain magnetic resonance imaging with diffusion tensor and diffusion-weighted imaging sequences was performed, together with microglia and macrophage activation and neurofilament light chain measurements.

Results
IDO−/− mice showed higher survival compared to wild-type mice (IDO−/− 11 of 16, wild-type 6 of 16, log-rank P = 0.036). Neurologic function was higher in IDO−/− mice than in wild-type mice after cardiac arrest (IDO−/− 9 ± 1, wild-type 7 ± 1, P = 0.012, n = 16). Indoleamine 2,3-dioxygenase deletion preserved locomotor function while maintaining physiologic circadian rhythm after cardiac arrest. Brain magnetic resonance imaging with diffusion tensor imaging showed an increase in mean fractional anisotropy in the corpus callosum (IDO−/− 0.68 ± 0.01, wild-type 0.65 ± 0.01, P = 0.010, n = 4 to 5) and in the external capsule (IDO−/− 0.47 ± 0.01, wild-type 0.45 ± 0.01, P = 0.006, n = 4 to 5) in IDO−/− mice compared with wild-type ones. Increased release of neurofilament light chain was observed in wild-type mice compared to IDO−/− (median concentrations [interquartile range], pg/mL: wild-type 1,138 [678 to 1,384]; IDO−/− 267 [157 to 550]; P < 0.001, n = 3 to 4). Brain magnetic resonance imaging with diffusion-weighted imaging revealed restriction of water diffusivity 24 h after cardiac arrest in wild-type mice; indoleamine 2,3-dioxygenase deletion prevented water diffusion abnormalities, which was reverted in IDO−/− mice receiving l-kynurenine (apparent diffusion coefficient, μm2/ms: wild-type, 0.48 ± 0.07; IDO−/−, 0.59 ± 0.02; IDO−/− and l-kynurenine, 0.47 ± 0.08; P = 0.007, n = 6).

Conclusions
The kynurenine pathway represents a novel target to prevent post–cardiac arrest brain injury. The neuroprotective effects of indoleamine 2,3-dioxygenase deletion were associated with preservation of brain white matter microintegrity and with reduction of cerebral cytotoxic edema.

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Evidence of Vestibular and Balance Dysfunction in Patients With Mild Cognitive Impairment and Alzheimer’s Disease
Authors: Bosmans Joyce , Gommeren Hanne , Gilles Annick , Mertens Griet , Van Ombergen Angelique , Cras Patrick , Engelborghs Sebastiaan , Vereeck Luc , Lammers Marc J.W. , Van Rompaey Vincent 
Published: July 2023

Objectives:
Given the expected rise in dementia prevalence, early diagnosis is vital. As a growing body of literature has identified a potential association between vestibular function and cognition, vestibular assessment may aid in early screening. The aim of the study was to better comprehend the proposed association between vestibular function and Alzheimer’s disease (AD) by comparing vestibular parameters (vestibular function testing and clinical balance measures) between a group with mild cognitive impairment (MCI), AD, and healthy controls with age-normal cognition.

Design:
Cross-sectional analysis of the GECkO study, an ongoing prospective single-center longitudinal cohort study. This study included 100 older adults (55 to 84 years). A total of 33 participants with MCI, 17 participants with AD, and 50 participants of age, sex, and hearing-matched healthy controls were included.

Results:
Participants with AD demonstrated a delayed latency of the p13 component measured by cervical vestibular-evoked myogenic potentials (cVEMP) compared with healthy controls and participants with MCI. Other measures including n23 latency, presence of intact responses, rectified amplitude, mean rectified voltage (measured by cVEMP) and lateral vestibulo-ocular reflex gain (measured by video Head Impulse Test [vHIT]) did not differ between groups. The Timed Up and Go (TUG), Performance-Oriented Mobility Assessment—Balance subscale (POMA-B), and Functional Gait Assessment (FGA) differed significantly between the three groups. Here, more cognitively impaired groups were associated with worse clinical balance scores.

Conclusions:
Vestibular and balance deficits were more prevalent in groups with increasing cognitive decline. Regarding vestibular function testing, p13 latency as measured by cVEMP was delayed in participants with AD. Other cVEMP or vHIT measures did not differ between groups. All three clinical balance assessments (TUG, POMA-B, and FGA) resulted in worse scores along the AD continuum. Future research integrating vestibular parameters that add value (including otolith function testing, balance, and spatial navigation) is recommended to validate the association between vestibular function and cognition while avoiding redundant testing.
Effect of Computerized Tomography on Assessment and Surgical Planning for Olecranon Fractures
Authors: Hill J. Ryan , Bechtold Daniel A. , Gibian Joseph T. , Kuhn Andrew W. , Hong Zachery , Tatman Lauren M. , Aleem Alexander W. , Berkes Marschall B. , Zmistowski Benjamin M. 
Published: July 2023

ABSTRACT

Objectives:
1) Determine effects of computed tomography (CT) on reproducibility of olecranon fracture classification. 2) Determine effects of CT utilization on inter-observer agreement regarding management of olecranon fractures. 3) Evaluate factors associated with articular impaction.

Methods:
Seven surgeons retrospectively evaluated radiographs of 46 olecranon fractures. Each fracture was classified according to Colton, Mayo, OTA/AO systems. Observers determined if articular impaction was present and provided treatment plans. This was repeated at minimum six weeks with addition of CT. Descriptive and comparative statistics were performed and intra-class correlation coefficients (ICC) calculated.

Results:
Inter-rater agreement was near-perfect for all classifications using radiographs (ICC 0.91, 0.93, 0.89 for Colton, Mayo, OTA/AO) and did not substantially change with CT (ICC 0.91, 0.91, 0.93). Agreement was moderate regarding articular impaction using radiographs (ICC 0.44); this improved significantly with CT (ICC 0.82). Articular impaction was significantly associated with OTA/AO classification, with high prevalence of impaction in OTA/AO 2U1B1e (p<0.03). Agreement was substantial for chosen fixation construct using radiographs (ICC 0.71); this improved with CT (ICC 0.79). Utilization of CT changed fixation plans in 25% of cases. Agreement regarding need for void filler was fair using radiographs (ICC 0.37); this notably improved with CT (ICC 0.64).

Conclusions:
Utilization of CT for evaluating olecranon fractures led to significant improvements in inter-observer agreement for presence of articular impaction. Impaction was significantly associated with fracture pattern but not with patient-related factors. Addition of CT improved agreement regarding fixation construct and led to notable improvement in agreement regarding need for void filler.

Level of Evidence:
Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Psychosocial Effect of Brace Treatment in Adolescent Idiopathic Scoliosis
Authors: Bae Byeong Hoon , Ham Chang Hwa , Patel Udit , Suh Yunsun 
Published: July 2023

Study Design:
Retrospective cohort study.

Objective:
To evaluate psychosocial effect of brace treatment in adolescent idiopathic scoliosis (AIS) using EuroQoL 5-dimension (EQ-5D) depression and anxiety category.

Background:
AIS is a structural abnormality of the spine often affecting patients during the puberty, a critical period of developing psychosocial problems. Many questionnaires had been adapted to evaluate mental health and health-related quality of life of AIS patients. However, these questionnaires are often time consuming and difficult to obtain. Therefore, a simpler substitute—EQ-5D—was evaluated.

Methods:
This is a single-center retrospective cohort analysis of adult idiopathic scoliosis patients aged between 8 and 19, visiting outpatient’s clinic. Beck’s depression inventory, EQ-5D and EuroQoL visual assessment scale, and Objectified Body Consciousness Scale for Youth were compared between brace group and non-brace group of AIS patients. Furthermore, difference between male and female were evaluated within brace group.

Results:
None of the questionnaire showed significant difference between brace and non-brace group. However, when male and female patients were compared within brace group, female patients were significantly more susceptible to depression and anxiety based on EQ-5D and body consciousness. Furthermore, depression and anxiety according to both BDI and EQ-5D were significantly correlated to health-related quality of life.

Conclusion:
During brace treatment of female AIS patients, psychosocial status played a significant role in health-related quality of life. EQ-5D is a simple way to monitor the mental health status.
A Surgical Treatment Algorithm for Restoring Pelvic Balance and Health-related Quality of Life in High-grade Lumbosacral Spondylolisthesis
Authors: Mac-Thiong Jean-Marc , Hresko M Timothy , Alzakri Abdulmajeed , Parent Stefan , Sucato Dan J. , Lenke Lawrence G. , Marks Michelle , Goulet Julien , Labelle Hubert 
Published: July 2023

Study Design:
Retrospective multicenter cohort-study.

Objective:
We propose an evidence-based surgical algorithm for achieving normal pelvic balance while optimizing health-related quality of life (HRQoL) in high-grade spondylolisthesis.

Summary of Background Data:
The principles of surgical treatment for young patients with high-grade L5-S1 spondylolisthesis remain unclear. There is a growing body of evidence supporting the central role of pelvic balance in the postural control and biomechanics of subjects with high-grade spondylolisthesis.

Methods:
This retrospective study assessed a multicenter cohort of 61 patients with high-grade L5-S1 spondylolisthesis. Classification and regression tree analysis was used to identify objective criteria associated with pelvic balance and HRQoL after surgery.

Results:
The most important predictor of a postoperative balanced pelvis was a postoperative L5 incidence ≤63.5 degrees. With postoperative L5 incidence ≤63.5 degrees,a residual slip percentage 9% and performing an L5-S1 posterior lumbar interbody fusion (PLIF)/transforaminal lumbar interbody fusion (TLIF) increased the likelihood of achieving a balanced pelvis postoperatively. When L5 incidence was 63.5 degrees,a balanced pelvis was most likely achieved with fusion limited to L5 proximally, residual slip percentage ≤40%, and residual lumbosacral angle 98 degrees. Predictors of postoperative HRQoL were the preoperative HRQoL score, L5 incidence and slip percentage.

Conclusions:
A surgical algorithm is proposed to achieve normal pelvic balance, while optimizing HRQoL. The first step during surgery is to assess L5 incidence and if L5 incidence is <65 degrees, the next step depends on the pelvic balance. With a preoperative balanced pelvis, it is important not to reduce completely the slip percentage by leaving a slip percentage ≥10%. When the preoperative pelvis is unbalanced, a TLIF/PLIF at L5-S1 is recommended to facilitate correcting the angular deformity at L5-S1. If L5 incidence is ≥65 degrees,a TLIF/PLIF at L5-S1 should be performed to correct the angular deformity at L5-S1, and fusion should ideally end at L5 proximally, in addition to performing gradual reduction of the slip percentage. If fusion up to L4 is required, a lumbosacral angle ≥100 degrees is key.
Short-Term and Mid-Term Outcomes of Indocyanine Green Fluorescence Imaging Guided Laparoscopic Right-Sided Colectomy: A Propensity Score-Matched Cohort Study
Authors: Daibo Susumu , Watanabe Jun , Suwa Hirokazu , Sato Seiya , Suwa Yusuke , Ozawa Mayumi , Ishibe Atsushi , Endo Itaru 
Published: July 2023

BACKGROUND:
With the use of indocyanine green fluorescence imaging, intraoperative lymphatic flow assessment is possible. However, there is no report which indicates mid-term outcomes of indocyanine green fluorescence imaging guided laparoscopic right-sided colectomy.

OBJECTIVE:
The purpose of this study was to examine the mid-term outcomes of indocyanine green fluorescence imaging guided laparoscopic right-sided colectomy.

DESIGN:
This was a retrospective, multi-institutional study with propensity score matching.

SETTINGS:
We conducted this study within the framework of the Yokohama Clinical Oncology Group in Japan.

PATIENTS:
A total of 921 patients who underwent laparoscopic right-sided colectomy with lymph node dissection for colon cancer with clinical stage I to III between January 2009 and December 2020 were included. The patients were divided into two groups: 233 patients who underwent the lymphatic flow evaluation (indocyanine green group) and 688 patients who did not undergo lymphatic flow evaluation (non-indocyanine green group).

MAIN OUTCOMES MEASURES:
The 3-year relapse-free survival after laparoscopic right-sided colectomy with and without indocyanine green fluorescence imaging were compared.

RESULTS:
After propensity score matching, 231 patients were matched in each group. The numbers of dissected central lymph nodes (6 vs 4, p < 0.001), and intermediate lymph nodes (7 vs 6, p = 0.03), and the total number of dissected lymph nodes (31 vs 27, p = 0.047) were significantly higher in the indocyanine green group. The median follow-up was 36.9 months. The estimated respective 3-year relapse-free survival and overall survival rates were 88.8% and 94.5% in the indocyanine green group and 89.4% and 94.7% in the non-indocyanine green group (p = 0.721 and 0.300), with no difference between the two groups.

LIMITATIONS:
The limitations of this study include its retrospective design.

CONCLUSIONS:
Indocyanine green fluorescence imaging guided laparoscopic right-sided colectomy could increase the number of totals, intermediate and central lymph nodes. However, there was no difference in mid -term outcomes.
Multimodal Imaging in Non-Exudative Choroidal Neovascularization: a Pilot Study of Status of Retinal Pigment Epithelium
Authors: Maltsev Dmitrii S. , Kulikov Alexei N. , Perminova Sophia M. , Burnasheva Maria A. , Vasiliev Alexander S. 
Published: July 2023

Abstract

Purpose:
To study the status of retinal pigment epithelium (RPE) in non-exudative and active choroidal neovascularization (CNV) in neovascular age-related macular degeneration (nAMD).

Methods:
Only treatment-naïve nAMD patients were enrolled in this prospective case-control study, including 17 eyes with non-exudative CNV (six males and 11 females, 74.9 ± 10.0 years) and 28 eyes with active CNV (eight males and 20 females, 69.3 ± 6.8 years). All patients received a comprehensive ophthalmic examination, optical coherence tomography (OCT), dark-field scanning laser ophthalmoscopy (DF-SLO), and fundus autofluorescence (FAF). The status of RPE was assessed with ImageJ software as the brightness of the CNV region on transillumination OCT, DF-SLO, and FAF images. CNV vessel density was measured based on OCT angiography.

Results:
The brightness of CNV region in non-exudative CNV was statistically significantly lower than in active CNV with both OCT transillumination (p = 0.004) and DF-SLO (p = 0.0015). No difference in brightness of CNV region between non-exudative and active CNV was found based on FAF (p = 0.44). The vessel density of non-exudative CNV was statistically significantly higher than that of active CNV with a median value of 64.5% (95% confidential interval (CI) 53.4 – 79.0 %) and 55.3% (95% CI 52.2 – 60.0%), respectively (p = 0.05).

Conclusion:
Multimodal imaging revealed substantial alteration of RPE in active CNV but not in non-exudative CNV which correlates with the higher vessel density of non-exudative CNV.
Reliability and Agreement of Keratometry Measurements Obtained With Eye Surface Profilometry and Partial Coherence Interferometry
Authors: Martínez-Plaza Elena , Molina-Martín Ainhoa , Piñero David P. 
Published: July 2023

Purpose:
The aim of this study was to assess the repeatability of keratometry parameters obtained using the Eye Surface Profiler (ESP) system and their agreement with the IOL Master 500 device.

Methods:
Seventy-one eyes of 71 healthy participants were evaluated. Three repeated measurements were performed using the ESP system. Simulated keratometry in the flat (SimKf) and steep (SimKs) meridians, astigmatism, and axis were obtained. The same parameters were measured using the IOL Master 500 device. The J0 and J45 vector components of the astigmatism were calculated. The intrasession repeatability was analyzed using within-subject SD (Sw) and intraclass correlation coefficient (ICC). Agreement was assessed using paired statistical tests and the Bland–Altman method.

Results:
The Sw was 0.07 mm, 0.04 mm, 0.51 D, 0.33 D, and 0.22 D, and the ICC was 0.96, 0.98, 0.74, 0.61, and 0.55 for SimKf, SimKs, astigmatism, J0, and J45, respectively. The mean difference and limits of agreement when comparing the ESP system with the IOL Master 500 device were 0.37 mm (0.08/0.66) for SimKf (P < 0.001), 0.18 mm (0.00/0.35) for SimKs (P < 0.001), −0.93 D (−2.42/0.56) for astigmatism (P < 0.001), 0.51 D (−0.22/1.24) for J0 (P < 0.001), and 0.06 D (−0.48/0.60) for J45 (P = 0.09).

Conclusions:
The ESP system provides consistent values for simulated keratometry, showing moderate consistency for astigmatism parameters. Contact lens practitioners should be aware that the ESP system and IOL Master 500 device provide different simulated keratometry from a clinically viewpoint.
External Compressive Ischemic Orbitopathy: A Rising Clinical Entity
Authors: Ghiam Benjamin K. , Liu Brian J. , Echegaray Jose J. , Prendes Mark A. 
Published: July 2023

Purpose:
Saturday night retinopathy, the term coined by Jayam et al. in 1974, is a rare condition in which external compression of the orbit during a drug and alcohol stupor causes a unilateral orbitopathy with ophthalmoplegia and ischemic retinopathy. This condition has been increasingly reported in the last decade, correlating with an increasing burden of substance use. This condition mirrors a similar entity typically reported in patients following spinal surgery, where a headrest supporting the patient’s face compresses the orbit. The current authors combine these 2 entities, entitled external compressive ischemic orbitopathy, and present a comprehensive literature review describing this entity.

Methods:
A systematic review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All related publications of vision loss in the setting of orbital compression were reviewed. Data collected included patient demographics, precipitating circumstances of vision loss, presenting ocular symptoms, outcomes, and ancillary imaging.

Results:
In total 31 articles were selected for inclusion, yielding 46 patients. A total of 10 patients suffered orbitopathy in the setting of a drug stupor, and 36 following prone-positioned surgery. However, 79% of patients presented with visual acuity of light perception or worse. Also, 86% of patients presented with ophthalmoplegia, 92% with proptosis and orbital edema, and 86% with varying degrees of retinal ischemia. When compared with iatrogenic cases, self-induced stuporous cases demonstrated worse presenting visual acuity, ophthalmoplegia, retinal and choroidal filling, and worse final outcomes.

Conclusion:
External compressive ischemic orbitopathy is a severe vision-threatening condition that has been increasingly reported in the last decade.
Interobserver agreement between central topography and Scheimpflug tomography for premium intraocular lens selection
Authors: Brar Sheetal , Ganesh Sri , Murkey Vedant 
Published: July 2023

Purpose:
To assess the inter-observer agreement and reliability of central topography (CT) of IOL Master 700 with that of Pentacam HR, as a screening tool for determining the suitability for premium (toric, monofocal and presbyopia correcting) intraocular lens (IOL) implants.

Setting:
Nethradhama Superspeciality Eye Hospital, Bangalore, India.

Method:
200 eyes of eligible patients undergoing unilateral or bilateral phacoemulsification with premium IOL's were included in the study. Preoperatively, IOL Master 700 CT and Pentacam scans were performed for corneal topography evaluation. 2 experienced clinicians were randomised to interpret the axial map of either of the scans at a time and their responses were then enclosed in an envelope, and forwarded to a third observer for analysis. If there was a conflict, final decision was based on the interpretation of the Pentacam scan.

Results:
Of the total scans interpreted by the 2 observers, 77.5% (n = 155) showed agreement whereas 22.5% (n = 45) showed disagreement. The sensitivity, specificity, positive predictive value and negative predictive value (NPV) of IOL Master 700 CT in diagnosing irregular corneas when compared with Pentacam HR, was 72.73%, 78.09%, 29.09% and 95.86% respectively. The Cohen's κ inter-observer agreement value was 0.44, signifying a moderate degree of agreement, which was statistically significant (P < .00).

Conclusions:
High NPV of IOL Master CT suggested that the device efficiently ruled out irregular corneas, while any suspicious scan should be confirmed with Pentacam HR or a similar device for appropriate decision-making regarding premium IOL selection.

Trial Registration Number:
CTRI/2021/11/038053.