bluuebunny/crossref_metadata_2025_split huggingface dataset:
Visco-Circumferential-Suture-Trabeculotomy Versus Rigid-Probe Viscotrabeculotomy in Neonatal-Onset Primary Congenital Glaucoma
Authors: Elwehidy Ahmed S. , Bayoumi Nader H.L. , Elzeini Rasha M. , Abdelkader Amr 
Published: April 2023

Précis:
Angle procedures are safe and relatively effective for neonatal onset PCG. Watchful delay in intervention to close to the second month of life is helpful in ensuring diagnosis and making surgery more successful and easier.

Purpose:
The purpose of this study was to compare the surgical outcomes of visco-circumferential-suture-trabeculotomy (VCST) to rigid-probe double-entry viscotrabeculotomy (DEVT) and rigid-probe single-entry viscotrabeculotomy (SEVT) in infants with neonatal-onset primary congenital glaucoma (PCG).

Design:
This was a retrospective chart review.

Patients and Methods:
Retrospective chart review of 64 eyes of 64 infants with neonatal-onset PCG referred to Mansoura Ophthalmic Center in Mansoura, Egypt between February 2008 and November 2018. Study groups included VCST, DEVT, and SEVT, and follow-up covered 4 postoperative years. Complete (qualified) success was defined as intraocular pressure (IOP) ≤18 mm Hg and with 35% IOP reduction from baseline without (with) IOP-lowering medications or further surgical interventions, and without any sign of progression in corneal diameter, axial length, or optic disc cupping and without visual devastating complications.

Results:
The mean±SD age at presentation and at the surgery of the study children was 3.63±1.74 and 55.23±1.60 days, respectively. The mean±SD IOP and cup/disc ratio of all study eyes at presentation and at final follow-up were 34.91±0.82 mm Hg and 0.70±0.09 and 17.04±0.74 mm Hg and 0.63±0.08, respectively. Complete success was achieved in 54.5%, 43.5%, and 31.6% in the VCST, DEVT, and SEVT groups, respectively. A self-limited hyphema was the commonest complication in all groups.

Conclusions:
Angle procedures are safe and marginally effective for the surgical treatment of neonatal-onset PCG, bringing IOP under control for at least 4 years of follow-up. Circumferential trabeculotomy as a first-line treatment has more favorable outcomes than rigid-probe SEVT. Rigid-probe viscotrabeculotomy offers an alternative to the noncompleted circumferential procedure.
The Infection Profile and Survival of Children and Adolescents With COVID-19 Undergoing Cancer Treatment: A Cohort Study
Authors: de Andrade-Lima Ana Luiza Magalhães , Lins Mecneide Mendes , Borborema Maria do Céu Diniz , Matos Ana Paula Rodrigues , de Oliveira Kaline Maria Maciel , Gonçalves Mello Maria Júlia 
Published: April 2023

Objective:
The objective of this study was to evaluate the clinical evolution of coronavirus disease 2019 (COVID-19) in children and adolescents with cancer.

Methods:
Cohort involving patients undergoing cancer treatment, 19 years old and under, with the diagnosis of COVID-19 by real-time polymerase chain reaction, in a reference hospital, between March 2020 and November 2021. Data were collected from medical records and interviews with patients and/or guardians. The primary outcomes studied were severe/critical COVID-19 presentation, deaths from any cause and overall survival. The Cox proportional hazards multivariate regression analysis was performed to determine the risk of death.

Results:
Sixty-two participants were included, most (67.7%) were male, with a median age of 6.8 years. Severe/critical forms of COVID-19, observed in 24.2%, seemed to indicate that the pediatric population undergoing cancer treatment has a higher morbidity rate than the general pediatric population (8–9.2%). During follow-up (4.5–18 months), 20 patients (32.3%) completed their cancer treatment and 18 died (29%)—6 during hospitalization and 12 after discharge. In total 61.1% of deaths occurred within 63 days of a detectable real-time polymerase chain reaction. Patients with a higher risk of death presented with severe/critical COVID-19 [adjusted hazard risk (aHR): 8.51; 95% confidence interval (CI): 2.91–24.80; P < 0.00] solid tumors (aHR: 3.99; 95% CI: 1.43–11.12; P = 0.008) and diarrhea as a symptom of COVID-19 (aHR: 3.9; 95% CI: 1.23–12.73; P = 0.021).

Conclusions:
These findings support the impact that severe acute respiratory syndrome-associated coronavirus 2 infection has on the population of children and adolescents with cancer, not only regarding immediate severity but also in their survival rate. Further studies evaluating long-term outcomes of COVID-19 in children and adolescents with cancer should be encouraged.
Stridor in Tuberculosis and COVID-19 Coinfection
Authors: Moya-Smith TlalliAztlan , St. Louis Joshua 
Published: April 2023

Abstract
As the SARS-CoV-2 pandemic continues to affect millions across the globe, the risk of coinfection with tuberculosis (TB) threatens patients' health and challenges our diagnostic capabilities. Here, we present a case of TB with pulmonary and laryngeal involvement complicated by coinfection with COVID-19. This case illustrates the importance of laboratory and imaging findings to differentiate between COVID-19 and TB and explores the potential for steroid use in laryngeal TB.
The effect of repetitive topical applications of local anesthetics (EMLA) on experimental pain and itch (histaminergic and nonhistaminergic)
Authors: Aliotta Giulia Erica , Vecchio Silvia Lo , Elberling Jesper , Arendt-Nielsen Lars 
Published: April 2023

Background:
The effects of repeated topical applications of local anesthetics are poorly investigated as they may, in addition to analgesia, impact peripheral nerve endings in a cumulative manner. In the present study, the effects of 6 repetitive applications of eutectic mixture of lidocaine (EMLA 2.5% and prilocaine 2.5%) were investigated on experimentally induced pain, histaminergic and nonhistaminergic itch, and neurogenic inflammation.

Methods:
Four skin areas on the forearms of 24 subjects were randomized to receive 3 hours of application of EMLA or placebo twice a day for 3 consecutive days. After each application, superficial blood perfusion (SBP), mechanical (mechanically evoked itch, mechanical pain threshold, and mechanical pain sensitivity), and thermal sensitivity (warm detection threshold, heat pain threshold, and suprathreshold heat sensitivity) were assessed. After the last application of EMLA/placebo, histamine and cowhage was applied (2 areas each) and itch and pain intensity and SBP were assessed.

Results:
After 3 hours of EMLA application, significant mechanical and thermal hypoalgesia were found with no cumulative efficacy over the 3 days. EMLA alone had no effect on SBP. Significantly increased SBP, reduced cowhage-induced itch, but the unaffected histamine-induced itch was found when applying EMLA ahead of histamine and cowhage.

Conclusions:
EMLA induced a reduction of mechanical and thermal sensitivity without a cumulative-dose effect. EMLA reduced nonhistaminergic itch and pain but not the experimentally provoked histaminergic itch. Selective action of EMLA on polymodal C-fibers could explain these effects.
Development of a screening tool for assessment of climate change–related heat illness in the clinical setting
Authors: Bernhardt Jean M. , Breakey Suellen , Cox Rachel , Olayinka Oluwatomisin , Quinn Lisa , Simmonds Katherine , Atkin Kathryn , Sipe Margie , Nicholas Patrice K. 
Published: April 2023

ABSTRACT
Extreme heat contributes to heat-related illnesses resulting from heat intolerance, which is the inability to maintain a thermal balance to tolerate heat stress. In the United States, heat-related mortality for older persons has almost doubled in the past 20 years. Other populations at risk for heat-related illness (HRI) include children, pregnant people, those who work outside, young people participating in outdoor sports, and at-risk populations such as Black, indigenous, and populations of color. The classic heat tolerance test used for decades monitoring physiological responses to repetitive motions is impractical across large and potentially health challenged populations and does not identify environmental or social factors or specific vulnerable populations. To address this issue, we developed a heat-related illness screening tool (HIST) to identify individuals at risk for HRI morbidity and mortality based on their physical, environmental, and social vulnerabilities with an emphasis on populations of concern. The HIST has the potential to be used as routine clinical screening in the same way as other commonly used screening tools. Heat intolerance affects patient outcomes and quality of life; therefore, early screening with a simple, easy-to-administer screening tool such as the HIST can identify people at risk and refer them to services that address heat exposure and/or create safety nets to prevent heat-related illnesses.
Understanding and targeting erythroid progenitor cells for effective cancer therapy
Authors: Wang Qingfei , Poole Rylee A. , Opyrchal Mateusz 
Published: April 2023

Purpose of review
It is well described that tumor-directed aberrant myelopoiesis contributes to the generation of various myeloid populations with tumor-promoting properties. A growing number of recent studies have revealed the importance of the previously unappreciated roles of erythroid progenitor cells (EPCs) in the context of cancer, bringing the updated concept that altered erythropoiesis also facilitates tumor growth and progression. Better characterization of EPCs may provide attractive therapeutic opportunities.

Recent findings
EPCs represent a heterogeneous population. They exhibit crucial pro-tumor activities by secreting growth factors and modulating the immune response. Cancers induce potent EPC expansion and suppress their differentiation. Recent single-cell transcriptome and lineage tracking analyses have provided novel insight that tumor-induced EPCs are able to be transdifferentiated into immunosuppressive myeloid cells to limit T-cell function and immunotherapy. Therapeutic strategies targeting key factors of EPC-driven immunosuppression, reducing the amount of EPCs, and promoting EPC differentiation and maturation have been extensively investigated.

Summary
This review summarizes the current state of knowledge as to the fascinating biology of EPCs, highlights mechanisms by which they exert the tumor promoting activities, as well as the perspectives on future directions and strategies to target these cells for potential therapeutic benefit.
Long-term Outcomes After Pediatric Mandibular Reconstruction Using Vascularized FreeFibula Flap
Authors: Liu Shuo , Zhang Wen-Bo , Wang Yang , Mao Chi , Yu Guang-Yan , Peng Xin 
Published: April 2023

Background:
To evaluate the long-term outcomes of mandibular reconstruction with vascularized free fibula flap in pediatric patients.

Methods:
Consecutive cases of mandibular reconstruction with vascularized free fibula flaps in pediatric patients at Peking University School and Hospital of Stomatology between 1999 and 2019 were reviewed. Postoperative computed tomography (CT) data of all patients were collected at each postoperative follow-up point, and after the age of 18 years. The length and height of the grafted fibula and the length of the remaining mandible were evaluated by measuring the three-dimensional CT data using ProPlan CMF 3.0 software. Lower limb function was evaluated using the Enneking evaluation scale. Facial symmetry was self-evaluated and scored. Statistical analysis was performed on the data obtained.

Results:
Fourteen patients were included in this study. All flaps were successful. The CT measurement results showed growth in the length of the grafted fibula which reconstructed the mandibular ramus and the residual mandible (P < 0.05). The height of the grafted fibula remained stable (P > 0.05). Eight patients were followed-up until > 18 years of age, and the CT measurement results after 18 years showed an essentially symmetrical mandible profile (P > 0.05). All patients were satisfied with their postoperative facial symmetry. Enneking evaluation scores showed good recovery of lower limb functions.

Conclusion:
Vascularized free fibula flap for mandibular reconstruction in pediatric patients is safe and reliable while also providing good cosmetic and functional outcomes as it demonstrated positive growth.
Reconstruction of Concha-type Microtia Using A Delayed Postauricular Skin Flap
Authors: Li Gaofeng , Zhang Bo , Ding Wei , Ouyang Huawei , Long Xiren , Fu Anqi , Liu Xiaojia 
Published: April 2023

Summary:
How to remove and retain the relatively large residual auricle is important for concha-type microtia reconstruction. The authors present a method for concha-type microtia reconstruction using a delayed postauricular skin flap. A total of 40 patients with concha-type microtia who underwent ear reconstruction using a delayed postauricular skin flap were retrospectively examined. Reconstruction was performed in three stages. The first stage consisted of preparation of a delayed postauricular skin flap,and dealing with the residual auricle including removal of the upper residual auricular cartilage. In the second stage, an autogenous rib cartilage framework was placed and covered with a delayed postauricular skin flap, postauricular fascia flap, and autologous medium-thickness skin graft. The ear framework was carefully articulated and secured with the retained residual auricular cartilage in order to achieve a smooth junction between the two.The third stage involved modification of the reconstructed ear. Patients were followed for 12 months after ear reconstruction. All reconstructed auricles had a good appearance, and there was a smooth connection between the reconstructed auricle and the residual ear with similar color as well as a flat and thin scar. All patients were satisfied with the results.
Which Types of Stress Are Associated With Accelerated Biological Aging? Comparing Perceived Stress, Stressful Life Events, Childhood Adversity, and Posttraumatic Stress Disorder
Authors: Bourassa Kyle J. , Caspi Avshalom , Brennan Grace M. , Hall Katherine S. , Harrington HonaLee , Houts Renate , Kimbrel Nathan A. , Poulton Richie , Ramrakha Sandhya , Taylor Gregory A. , Moffitt Terrie E. 
Published: April 2023

ABSTRACT

Objective
Stress and stressful events are associated with poorer health; however, there are multiple ways to conceptualize and measure stress and stress responses. One physiological mechanism through which stress could result in poorer health is accelerated biological aging. This study tested which types of stress were associated with accelerated biological aging in adulthood.

Methods
Studying 955 participants from the Dunedin Longitudinal Study, we tested whether four types of stress assessed from ages 32 to 45 years—perceived stress, number of stressful life events, adverse childhood experiences, and posttraumatic stress disorder—were associated with accelerated biological aging.

Results
Higher levels of all four measures of stress were significantly associated with accelerated aging in separate models. In a combined model, more perceived stress and more stressful life events remained associated with faster aging, and the stress measures explained 6.9% of the variance in aging. The magnitudes of the associations between the four measures of stress and biological aging were comparable to associations for smoking and low education, two established risk factors for accelerated aging. People with high levels of perceived stress, numerous adverse childhood experiences (4+), high stressful life event counts, or posttraumatic stress disorder were aging an additional estimated 2.4 months, 1.1 additional months, 1.4 months, and 1.4 months per year, respectively.

Conclusions
Assessing stress, particularly perceived stress, could help identify people at risk of accelerated aging. Intervening to treat stress or the health-relevant sequelae of stress could potentially slow the rate at which people are aging, improving their health as they age.
Immune Phenotype and Postoperative Complications After Elective Surgery
Authors: Moris Dimitrios , Barfield Richard , Chan Cliburn , Chasse Scott , Stempora Linda , Xie Jichun , Plichta Jennifer K. , Thacker Julie , Harpole David H. , Purves Todd , Lagoo-Deenadayalan Sandhya , Hwang Eun-Sil Shelley , Kirk Allan D. 
Published: April 2023

Objectives:
To characterize and quantify accumulating immunologic alterations, pre and postoperatively in patients undergoing elective surgical procedures.

Background:
Elective surgery is an anticipatable, controlled human injury. Although the human response to injury is generally stereotyped, individual variability exists. This makes surgical outcomes less predictable, even after standardized procedures, and may provoke complications in patients unable to compensate for their injury. One potential source of variation is found in immune cell maturation, with phenotypic changes dependent on an individual’s unique, lifelong response to environmental antigens.

Methods:
We enrolled 248 patients in a prospective trial facilitating comprehensive biospecimen and clinical data collection in patients scheduled to undergo elective surgery. Peripheral blood was collected preoperatively, and immediately on return to the postanesthesia care unit. Postoperative complications that occurred within 30 days after surgery were captured.

Results:
As this was an elective surgical cohort, outcomes were generally favorable. With a median follow-up of 6 months, the overall survival at 30 days was 100%. However, 20.5% of the cohort experienced a postoperative complication (infection, readmission, or system dysfunction). We identified substantial heterogeneity of immune senescence and terminal differentiation phenotypes in surgical patients. More importantly, phenotypes indicating increased T-cell maturation and senescence were associated with postoperative complications and were evident preoperatively.

Conclusions:
The baseline immune repertoire may define an immune signature of resilience to surgical injury and help predict risk for surgical complications.
“I Came up Short on the Academic Ladder”
Authors: Isak Ergest , Hegde Yash D. , Barrett Meredith , Mazer Laura M. , Dimick Justin B. , Sandhu Gurjit 
Published: April 2023

Objective:
This study aims to explore the definition of career success in academic surgery.

Background:
Career success in academic surgery is frequently defined as the achievement of a specific title, from full professor to department chair. This type of definition is convenient and established but potentially incomplete. The business literature has a more nuanced view of the relationship between titles and success, but this relationship has not been studied in medicine.

Methods:
Semi-structured interviews were conducted from May to November 2020. Data were analyzed in an iterative fashion using grounded theory methodology to develop a conceptual model.

Results:
We conducted 26 semi-structured interviews with practicing surgeons differing in years of experience; 12 (46%) participants were female, mean age of 48. Participants included 5 chairs of surgery, 6 division chiefs, and 7 past or current presidents of national societies. Four themes emerged on the importance of titles: Some study participants reported that (1) titles are a barometer of success; others argued that (2) titles are not a sufficient metric to define success; (3) titles are a means to an end; and (4) there is a desire to achieve the title of a respected mentor.

Conclusions:
As the definition of career success in academic surgery changes to encompass a broader range of interests and ambitions, the traditional markers of success must come into review. Academic surgeons see the value of titles as a marker of success and as a means to achieving other goals, but overwhelmingly our interviewees felt that titles were a double-edged sword and that a more inclusive definition of academic success was needed.
The Prevalence of the Female Athlete Triad in Female Service Members
Authors: Mattison Cameron S. , Wiese John 
Published: April 2023

AbstractOsteoporosis, amenorrhea, and low energy with or without disordered eating (the female athlete triad) are frequent clinical outcomes associated with female athletes in constant low energy availability (LEA). The rigorous training demands of the Army and the strict weight limits suggest that female service members may be susceptible to states of LEA, where energy expenditure exceeds dietary energy intake.To understand the prevalence of the female athlete triad among female service members and how restrictive weight requirements influence these symptoms, we compared survey responses measuring symptoms of the female athlete triad between female active-duty service members and female veterans.The results indicated that female veterans had significantly higher female athlete triad and disordered eating scores. Therefore, female veterans are more likely to demonstrate female athlete triad symptoms than active-duty service members. Specifically, female veterans are more likely to demonstrate symptoms of low energy with or without disordered eating.Female veterans’ unique stressors of no longer being in the military (reintegration into society and losing support system within the military) could be why they are more likely to present with female athlete triad symptoms than active-duty female service members.
Reduced male fertility of an Antarctic mite following extreme heat stress could prompt localized population declines
Authors: Benoit Joshua B. , Finch Geoffrey , Ankrum Andrea L. , Niemantsverdriet Jennifer , Paul Bidisha , Kelley Melissa , Gantz J. D. , Matter Stephen F. , Lee Richard E. , Denlinger David L. 
Published: April 2023

AbstractClimate change is leading to substantial global thermal changes, which are particularly pronounced in polar regions. Few studies have examined the impact of heat stress on reproduction in Antarctic terrestrial arthropods, specifically how brief, extreme events may alter survival. We observed that sublethal heat stress reduces male fecundity in an Antarctic mite, yielding females that produced fewer viable eggs. Females and males collected from microhabitats with high temperatures showed a similar reduction in fertility. This impact is temporary, as indicated by recovery of male fecundity following return to cooler, stable conditions. The diminished fecundity is likely due to a drastic reduction in the expression of male-associated factors that occur in tandem with a substantial increase in the expression of heat shock proteins. Cross mating between mites from different sites confirmed that heat-exposed populations have impaired male fertility. However, the impact on fertility declines with time when the mites are allowed to recover under less stressful conditions, suggesting that the negative effects are transient. Modeling indicated that heat stress is likely to reduce population growth and that short bouts of non-lethal heat stress could have substantial effects on local populations of Antarctic arthropods.
MGAT5 (GnTase-V) products are overexpressed in primary osteoblastic osteogenic sarcoma
Authors: McClure John , McClure Sheena F 
Published: April 2023

ABSTRACTIt is well documented that MGAT5 (Glycosyltransferase V) products are over expressed in carcinomas and likely accelerate metastasis by promoting neoangiogenesis. We now report a similar over expression in primary osteoblastic osteogenic sarcoma and demonstrate new intratumoural blood vessels. Expansion of the tumours is by osteoclastic resorption of both trabecular and cortical bone with the latter by cutting channels similar to physiological cutting cones. Osteoclasts, adjacent capillaries, and related mast cells also overexpress MGAT5 products and we speculate that this facilitates neoangiogenesis.