bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retinal Tectonics after Macular Pucker Surgery: Thickness Changes and En-Face Displacement Recovery
Authors: Scarinci Fabio , Querzoli Giorgio , Cosimi Pamela , Ripandelli Guido , Romano Mario R. , Cacciamani Andrea , Munk Marion R. , Rossi Tommaso 
Published: September 2023

Abstract

Purpose:
To study visual function, retinal layer thickness changes and tangential displacement after Pars Plana Vitrectomy (PPV) for EpiRetinal Membrane (ERM).

Methods:
Retrospective series of patients undergoing PPV for ERM, with 6-month follow-up including best-corrected visual acuity (BCVA), Optical Coherence Tomography (OCT), M-charts, ERM grading, and InfraRed fundus photo at time 0 (T0, pre-op) at month 1 (T1), 3 (T3), 6 (T6) post-op (±1 week). Retinal layer thickness and tangential (en-face) retinal displacement between successive times for the entire retinal surface and the central horizontal and vertical meridian were also measured. En-face displacement was calculated as optical flow of consecutive images.

Results:
Average BCVA improved from 0.28±0.08 logMAR at T0 to 0.16±0.25 at T6 (p=0.05), BCVA improvement correlated with BVCA at T0 (p<0.001). Vertical metamorphopsia decreased from 1.33°±0.70° at T0 to 0.82°±0.69° at T6 (p<0.05). Foveal thickness reduced from 453±53µm at T0 to 359±31µm at T6 (p<0.05) and reduction correlated with BCVA improvement (p<0.05). Foveal layers decreased (p<0.05) in all cases. Mean en-face deformation was 155.82±50.17µm and mostly occurred in the first month: T0-T1 displacement was 83.59±30.28µm, T1-T3 was 36.28±14.45µm, while T3-T6 was 39.11±22.79µm (p<0.001) on average. Peri-foveal and parafoveal deformation correlated with OCT foveal thickness reduction at all time intervals (1, 3, 6 months: p<0.01).

Conclusion:
ERM peeling affects all retinal layer thickness and results in new force balance across the entire retina and tangential displacement. Both en-face and in-depth changes correlate with visual function.
Orbital Liposarcoma: A Surveillance, Epidemiology and End Results Database Study
Authors: Chen Teresa , Roelofs Kelsey A. , Baugh Samuel , Esfandiari Mahtash , Rootman Daniel B. 
Published: September 2023

Purpose:
Orbital liposarcoma is a challenging tumor to treat due to its rarity and high rate of local recurrence, and the role of radiotherapy and chemotherapy remain unclear. Analysis of big data may improve our overall understanding of orbital disease and role of adjuvant therapies.

Methods:
Data were extracted from the Surveillance, Epidemiology and End Results (SEER) Research Plus database from 1975 to 2017. All patients with a diagnosis of liposarcoma (ICD-O3 codes 8850-8858, 8869-8862, 8870, 8880, 8881) were included. Cases were divided into 4 groups by primary site: orbit, retroperitoneum, soft tissue, and other.

Results:
A total of 16,958 patients were included. Patients with orbital involvement were younger and more likely to be female (p < 0.05). Among orbital lesions, myxoid liposarcoma was the most common histologic subtype (6/19; 31.6%) followed by well differentiated (5/19; 26.3%). This differed from the distribution of histologic subtypes encountered elsewhere, for which well-differentiated liposarcoma was the most common (retroperitoneum 979/3,136; 31%, soft tissue 3,493/11,671; 30%, and other sites 497/2,132; 23%, p < 0.05). Dedifferentiated histologic subtype was the second most common subtype found in the retroperitoneum (946/3,136; 30%), whereas it was less common in the orbit (2/19; 11%) and soft tissue (1,396/11,671; 12%) (p < 0.001). Patients with orbital liposarcoma had similar disease-specific mortality compared with soft-tissue location (p = 0.825) and lower disease-specific mortality compared with retroperitoneal location (p < 0.001). When all locations were combined, patients with well-differentiated liposarcoma had the lowest disease-specific mortality.

Conclusions:
Patients with orbital liposarcoma tend to be younger, female, and have a better prognosis than those with retroperitoneal disease, likely due to the lower incidence of dedifferentiated histologic subtype.
Neutrophil-to-Lymphocyte Ratios Distinguish Idiopathic Orbital Inflammation From Orbital Infectious Disease
Authors: Wladis Edward J. , Bohnak Carisa E. , Law James J. , Adam Alejandro P. , Rothschild Michael I. , Pauze Denis R. 
Published: September 2023

Purpose:
The neutrophil-to-lymphocyte ratio (NLR) is a relatively novel biomarker to distinguish between acute stresses. This study was performed to determine whether the NLR may discern infectious orbital maladies from idiopathic orbital inflammation (IOI).

Methods:
The NLR was calculated by a review of the initial blood draws of adult patients who presented to the emergency department at a single academic medical center. Statistical comparisons were performed to identify the significance of these results.

Results:
Ten patients with IOI, 12 patients with necrotizing fasciitis (NF), and 12 patients with orbital cellulitis (OC) presented to the emergency department. The groups were not statistically significantly different in terms of age or gender. The mean NLRs were 3.48 (standard deviation = 1.80), 13.5 (standard deviation = 14.5), and 8.15 (standard deviation = 6.56) for IOI, NF, and OC, respectively. Patients with IOI had statistically significantly lower NLRs than patients with NF (p = 0.037) and OC (p = 0.034). However, the NLRs of patients with OC were not statistically significantly different from those of patients with NF (p = 0.27).

Conclusions:
The NLR appears to distinguish IOI from infectious etiologies, but does not discern between variants of infection. These results should be juxtaposed against appropriate imaging and clinical evaluations, but elevated NLR values may heighten clinicians’ concerns for an infectious process and encourage them to initiate appropriate management steps.
A Quality Improvement Project
Authors: Joy Julija A. , Gunn Jennie , Mulekar Madhuri S. 
Published: September 2023

Abstract

Purpose
This quality improvement project was introduced at an addiction treatment center to implement the Centers for Disease Control and Prevention's (CDC's) hepatitis C virus (HCV) treatment guidelines and offer anticraving medications to patients to improve standards of care of patients with substance use disorders.

Literature Review
Patients with opioid use disorders are at the highest risk of contracting HCV. More than 80% of people in the United States with opioid use disorders who use intravenous drugs have contracted HCV. Despite the high prevalence of HCV, patients at treatment centers are being screened only for HCV antibodies (HCV-AB) and are not receiving the CDC's HCV treatment guidelines. The CDC has treatment recommendations of hepatitis panels, full STD testing, and early follow-up care.

Method
This quality improvement project utilized the Plan-Do-Study-Act tool. With the application of Plan-Do-Study-Act, for patients identified with HCV-AB, the established CDC HCV treatment guidelines were followed, and the clinical progress of the implementation of the guidelines was monitored. Chart reviews comparing compliance of guidelines before and after the study were implemented.

Participants
A convenience sample of 125 patients were collected, and of these, 32 patients were found to be HCV-AB+.

Findings
The findings revealed that 18.75% of patients followed the CDC's HCV recommendations after the quality improvement project compared with 6.25% of patients before the intervention. The number of HIV testing offered increased by 40.00% as a result of the implementation of the project.
Associations Between Gender-Specific Substance Use Patterns and Mental Health Among Adolescents in the Republic of Korea
Authors: Lee Haein , Lee Bo Gyeong 
Published: September 2023

Abstract

Purpose
Although gender differences in adolescent substance use are complex and substance use accompanies mental health problems, most previous studies have focused on gender-specific association between single substance use and mental health. This study aimed to investigate gender-specific substance use patterns and to examine their association with mental health characteristics.

Methods
Nationally representative data from the Korea Youth Risk Behavior Survey collected in 2018 were analyzed. To identify substance use patterns among male adolescents (n = 30,463) and female adolescents (n = 29,577), multiple-group latent class analysis was conducted using eight substance use indicators. In addition, we conducted a latent class analysis with covariates to examine the association between substance use patterns and mental health characteristics.

Results
Among both gender samples, the four-class model best fit the data: nonusers (86.4%), frequent smokers (2.9%), risky drinkers (7.1%), and heavy tobacco and alcohol users with lifetime heated tobacco product use (3.6%) for male adolescents, and nonusers (89.8%), frequent smokers (0.5%), risky drinkers (8.0%), and heavy tobacco and alcohol users with a drunkenness episode (1.7%) for female adolescents. Depression, suicidal plans, and suicidal attempts predicted the latent class model for both genders. In addition, stress level predicted the latent class model for female adolescents.

Conclusions
The findings indicate that homogeneous patterns of substance use by gender are differentially associated with mental health problems. Therefore, health professionals should develop interventions tailored to gender-specific substance use patterns, taking into account the mental health characteristics of each pattern.
Prescription Stimulant Misuse Among Nursing Students
Authors: Magnotti Sebastian , Beatty Avery , Bickford Erek , Channell Isabella , Weyandt Lisa 
Published: September 2023

Abstract
Nonmedical prescription stimulants are used to reduce symptoms of inattention, impulsivity, and hyperactivity in children and adults with attention-deficit hyperactivity/disorder. They are Schedule II controlled substances because of their high potential for dependence, and individuals who misuse them without a valid prescription are subject to criminal charges. Stimulant medications are also associated with common side effects (e.g., insomnia) as well as more serious but less common side effects (e.g., arrhythmias). Despite the potential health and legal consequences, misuse of prescription stimulants has become a public health crisis on college campuses in the United States. Neurocognitive enhancement is the primary reason that college students report misusing prescription stimulants, despite no enhancement of cognitive functioning when taken by healthy adults. Nursing students may be at risk for misuse because of their high levels of academic and clinical demands and because many start misusing in nursing school. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the databases PubMed, Science Direct, EBSCOhost, and Academic OneFile were systematically searched to investigate the (a) percentage of prescription stimulant misuse studies that have included nursing students, (b) prevalence of prescription stimulant misuse among nursing students, (c) motivations for prescription stimulant misuse among nursing students, and (d) demographic factors associated with increased use among nursing students. Results revealed that of the 197 studies conducted within the past decade (2010–2021), only 1.02% (two) included nursing students. Future studies must investigate the prevalence and nature of prescription stimulant misuse among nursing students.
The impact of serum estradiol and progesterone levels during implantation on obstetrical complications and perinatal outcomes in frozen embryo transfer
Authors: Lin Yi-Lun , Ho Chung-Han , Chung Ming-Ting , Lin Liang-Yin , Hsiao Tsun-Wen , Chen Yi-Ting , Wen Jen-Yu , Tsai Yung-Chieh 
Published: September 2023

Background:
This study sought to evaluate obstetric complications and perinatal outcomes in frozen embryo transfer (FET) using either a natural cycle (NC-FET) or a hormone therapy cycle (HT-FET). Furthermore, we investigated how serum levels of estradiol (E2) and progesterone (P4) on the day of and 3 days after embryo transfer (ET) correlated with clinical outcomes in the two groups.

Methods:
We conducted a retrospective, single-center study from January 1, 2015, to December 31, 2019. The study included couples who underwent NC-FET or HT-FET resulting in a singleton live birth. Serum levels of E2 and P4 were measured on the day of and 3 days after ET. The primary outcomes assessed were preterm birth rate, low birth weight, macrosomia, hypertensive disorders in pregnancy, gestational diabetes mellitus, postpartum hemorrhage, and placenta-related complications.

Results:
A total of 229 singletons were included, with 49 in the NC-FET group and 180 in the HT-FET group. There were no significant differences in obstetric complications and perinatal outcomes between the two groups. The NC-FET group had significantly higher serum levels of P4 (17.2 ng/mL vs 8.85 ng/mL; p < 0.0001) but not E2 (144 pg/mL vs 147 pg/mL; p = 0.69) on the day of ET. Additionally, 3 days after ET, the NC-FET group had significantly higher levels of both E2 (171 pg/mL vs 140.5 pg/mL; p = 0.0037) and P4 (27.3 ng/mL vs 11.7 ng/mL; p < 0.0001) compared with the HT-FET group.

Conclusion:
Our study revealed that although there were significant differences in E2 and P4 levels around implantation between the two groups, there were no significant differences in obstetric complications and perinatal outcomes. Therefore, the hormonal environment around implantation did not appear to be the primary cause of differences in obstetric and perinatal outcomes between the two EM preparation methods used in FET.
Four Assessment Tools for Predicting Mortality and Adverse Events in Surgical Patients With Sepsis and Septic Shock: A Comparative Study
Authors: CHU Yi-Chin , LIU Yi , WENG Shih-Feng , CHEN Chao-Wen 
Published: September 2023

ABSTRACT

Background
The mortality rate for sepsis and septic shock in surgical patients is approximately 36%, which is higher than that of other medical patients. Predisposition, infection/injury, response, and organ dysfunction (PIRO) is currently the most widely used tool for assessing patients with surgical sepsis. However, it is not a standardized assessment tool for surgical patients in general.

Purpose
The purposes of this study were to (a) create a modified PIRO (mPIRO) that adds a count of platelets and does not include a body temperature reading; (b) test the sensitivity and specificity of the mPIRO for predicting mortality and adverse events among patients with surgical sepsis; and (c) compare the predictive accuracy of the mPIRO, sequential organ failure assessment (SOFA), quick SOFA, and PIRO tools.

Methods
A retrospective observational cohort study was conducted. Two thousand fifty-five patient medical records were reviewed, with 103 identified as meeting the inclusion criteria.

Results
Compared with the other tools, mPIRO ≥ 4 achieved better sensitivity (90.5%) in predicting mortality and high sensitivity (72%) and specificity (80%) in predicting adverse events. mPIRO was the most accurate predictor of mortality (area under the receiver operating characteristic curve [AUC] = 0.83) among the tools considered. SOFA and mPIRO were the first and second most accurate predictor of adverse events, respectively, with respective AUC values of 0.86 and 0.82.

Conclusions/Implications for Practice
mPIRO, which employs an easy-to-use scoring system, is a valid assessment tool with good sensitivity and AUC for predicting both mortality and adverse events in patients with surgical sepsis. We recommend using mPIRO ≥ 3 as an indicator of potential adverse events.
Pediatric Optic Pathway Gliomas: A Report From Northern Greece
Authors: Panagopoulou Paraskevi , Athanasiadis Dimitrios , Αnastasiou Αthanassia , Zafeiriou Dimitrios , Papakonstantinou Εvgenia 
Published: September 2023

Optic pathway gliomas (OPGs) are the most common pediatric optic nerve tumors. Their behavior ranges between rapid growth, stability, or spontaneous regression. Τhey are characterized by low mortality albeit with significant morbidity. We present the characteristics, management, and outcome of 23 OPG patients (16 females, median age: 4.8 y) managed in a Pediatric Oncology Department in Northern Greece over a 25-year period. Overall, 57% had a background of neurofibromatosis type 1. Diagnosis was based on imaging (10 patients) or biopsy (13 patients). Presenting symptoms were mostly visual impairment/squint (52%). Proptosis/exophthalmos, raised intracranial pressure, and headache were also noted. In 2 occasions, it was detected with surveillance magnetic resonance imaging in the context of neurofibromatosis type 1. Eight patients had unilateral and 2 bilateral optic nerve tumors (Modified Dodge Classification, stage 1a/1b), 3 had chiasmatic (stage 2a/b), and 10 had multiple tumors (stage 3/4). Predominant histology was pilocytic astrocytoma (77%). Management included: observation (4), chemotherapy only (9), surgery only (3), or various combinations (7). Chemotherapy regimens included vincristine and carboplatin, vinblastine, or bevacizumab with irinotecan. Most patients demonstrated a slow disease course with complete response/partial response to chemotherapy and/or surgery, whereas 39% presented ≥1 recurrences. After a median follow-up of 8.5 years (range to 19 y), 20 patients (87%) are still alive with stable disease, in partial/complete remission, or on treatment.
Dyadic Hair Cortisol Self-Collection Procedure
Authors: Anderson Alison R. , Mahajan Ishika , Ford Jodi L. , Wright Kathy D. , Mackos Amy R. , Rose Karen M. , Monroe Todd B. , Moss Karen O. 
Published: September 2023

Background
At-home self-collection of specimens has become more commonplace because of measures taken in response to the coronavirus pandemic. Self-collection of hair cortisol is important because chronic stress is present in many populations, such as older adults living with Alzheimer’s disease and their family caregivers. For the evaluation of chronic stress, scalp hair can be used as a predictive biomarker because it examines the cumulative, retrospective stress from previous months.

Objectives
The aim of the paper is to provide a study procedure for at-home, scalp hair self-collection for cortisol concentration analysis from dyads consisting of a person living with Alzheimer’s disease and their family caregiver.

Methods
After informed electronic consent is obtained, a package containing the necessary tools for self-collection of hair samples from the dyad is mailed to the participant’s home. Participants are provided detailed print and video multimedia guides outlining how to obtain the hair samples. Ideally, the hair samples are obtained during the virtual data collection meeting with research personnel. Participants mail back the hair sample in a prepaid package to the biomedical laboratory for analysis.

Discussion
At-home, self-collection of hair provides potential advantages such as reduced participant burden, especially for vulnerable populations where transportation and different environments are challenging. At-home sample collection options may increase research participation and can be applied to multiple research foci. Research considerations for dyads, such as people living with Alzheimer’s disease and their caregivers, are discussed.
Comprehensive Clinical-Pathologic Assessment of Malignant Phyllodes Tumors
Authors: Turashvili Gulisa , Ding Qingqing , Liu Yi , Peng Limin , Mrkonjic Miralem , Mejbel Haider , Wang Yihong , Zhang Huina , Zhang Gloria , Wang Jigang , Wei Shi , Li Xiaoxian 
Published: September 2023

The latest World Health Organization classification of breast tumors recommends diagnosing malignant phyllodes tumors (MPTs) when all 5 morphologic features are present: permeative borders, marked stromal cellularity, marked stromal cytologic atypia, ≥10 mitoses per 10 high-power fields (HPF), and stromal overgrowth. We assessed the performance of this recommendation to capture MPTs and features predictive of distant metastasis in a multi-institutional retrospective study. Of 65 MPTs, most cases had at least focally permeative borders (58, 89%), with marked stromal cellularity in 40 (61.5%), marked atypia in 38 (58.5%), ≥10 mitoses per 10 HPF in 50 (77%), and stromal overgrowth in 56 (86%). Distant metastases were observed in 20 (31%) patients (median follow-up 24.5 mo, 1 to 204). Only 13 of 65 (20%) cases had all 5 morphologic features, while only 7 of 20 (35%) cases with distant metastases had all 5 features. In univariate analysis, only marked stromal atypia (P=0.004) and cellularity (P=0.017) were associated with decreased distant metastasis-free survival. In multivariate Cox regression, the combination of stromal overgrowth, marked stromal cellularity, and atypia (C-index 0.721, 95% CI: 0.578, 0.863) was associated with decreased distant metastasis-free survival. The current World Health Organization recommendation will miss a significant number of MPTs with distant metastases. We propose refined diagnostic criteria for MPTs: (1) stromal overgrowth combined with ≥1 feature(s) (marked cellularity, marked atypia, or ≥10 mitoses per 10 HPF), or (2) in the absence of stromal overgrowth, marked cellularity combined with ≥1 feature(s) (permeative borders, marked atypia, or ≥10 mitoses per 10 HPF).
Improved Reverse Postauricular Island Flap for Repair of Lower Conjunctival Fornix Retraction
Authors: Fan Jincai , Guo Rui 
Published: September 2023

Abstract:
Repair of lower conjunctival fornix retraction is a great challenge for plastic surgeons in the aspects of orbital prosthesis retaining and cosmetic appearance. Hereby, a 25-year-old woman, suffering from lower conjunctival fornix retraction after the removal of retinoblastoma and radiotherapy, was undertaking the treatment with an improved reverse postauricular island flap for expansion of the lower conjunctival fornix, and volume augmentation of the anophthalmic socket in one stage. The flap was based on the parietal branch of the superficial temporal artery and its vascular architecture to the postauricular vascular system, and successfully transferred by passing through a subcutaneous tunnel. The satisfactory result indicated that the mentioned technique may be a good option in surgical rehabilitation of the stable depth of the lower conjunctival fornix, not only from the reliable blood supply and the suitable thickness of the flap but also from the less donor morbidity without an exposed unsightly scar.

Level of Evidence:
Level V.