bluuebunny/crossref_metadata_2025_split huggingface dataset:
Concordance of Data About Sex From Electronic Health Records and the National Death Index
Authors: Blosnich John R. , Boyer Taylor L. 
Published: January 2022

Background:
Transgender individuals have greater health risks than cisgender individuals, which may bode for greater mortality. However, research is limited by lack of gender identity information at the time of death. Novel opportunities to combine administrative data with National Death Index (NDI) data may facilitate mortality research about transgender populations, but binary measures of sex and gender may pose problems for analyses. This study explored differences in sex recorded in Veterans Health Administration (VHA) electronic health record (EHR) and NDI data between transgender and cisgender decedents.

Methods:
We used VHA EHR data from fiscal years 2000–2016 to identify deaths among a sample of transgender and cisgender patients. We cross-tabulated sex recorded in the NDI with EHR-based sex from VHA EHR data. We extracted data in 2018 and conducted analyses in 2020.

Results:
Death occurred for 1109 transgender patients and 7757 cisgender patients. For cisgender decedents, EHR-based sex and NDI-based sex were 100% concordant. For transgender decedents, 46 (4%) were discordant between data sources. Of transgender decedents with female EHR-based sex (n = 259), 17% were indicated as male in NDI data; of those with male EHR-based sex (n = 850), 0.2% were indicated as female in NDI data.

Conclusions:
Data linkage between EHR and the NDI can facilitate transgender mortality research, but examining mortality specific to various transgender identities remains difficult. Improved documentation of sex and gender is needed within US mortality surveillance.
Long-term Exposure to Fine Particulate Matter and Mortality A Longitudinal Cohort Study of 400,459 Adults
Authors: Guo Cui , Yu Tsung , Bo Yacong , Lin Changqing , Chang Ly-yun , Wong Martin C. S. , Yu Zengli , Lau Alexis K. H. , Tam Tony , Lao Xiang Qian 
Published: January 2022

Background:
Cohort studies on the association between long-term exposure to fine particulate matter (PM2.5) and mortality have been well established for America and Europe, but limited and inconsistent in Asia with much higher air pollution. This study aims to investigate the associations between ambient PM2.5 and all-cause and cause-specific mortality over a period of rising and then declining PM2.5.

Methods:
We enrolled a total of 400,459 adults from an open cohort between 2001 and 2016, and followed them up until 31 May 2019. We obtained mortality data from the National Death Registry maintained by the Ministry of Health and Welfare in Taiwan. We estimated ambient PM2.5 exposures using a satellite-based spatiotemporal model. We performed a Cox regression model with time-dependent covariates to investigate the associations of PM2.5 with deaths from all causes and specific causes.

Results:
This study identified 14,627 deaths and had a total of 5 million person–years of follow-up. Each 10 µg/m3 increase in PM2.5 was associated with an increased hazard risk of 29% (95% confidence interval: 24%–35%) in all-cause mortality. Risk of death increased by 30% for natural causes, 20% for cancer, 42% for cardiovascular disease (CVD) causes, and 53% for influenza and pneumonia causes, for each 10 µg/m3 increase in PM2.5. Sensitivity analyses generally yielded similar results.

Conclusion:
Long-term exposure to ambient PM2.5 was associated with increased risks of all-cause mortality and deaths from cancers, natural causes, CVD, and influenza and pneumonia. Longitudinal study design should be encouraged for air pollution epidemiologic investigation.
The Bilateral Trans Alar Forehead Flap to Reconstruct the Cocaine Nose: A Case Report
Authors: Taams Karel O. , Taams Stephanie J. 
Published: January 2022

Summary:
Isolated circumferential lining contraction of the midvault and nasal floor is a challenging reconstructive problem. In the cocaine nose, extensive loss of mucosal lining, with or without loss of columella, will result in collapse of the nose into the pyriform fossa. Various techniques have been used to provide nasal lining, but when the defect is extensive a free tissue transfer is advocated. The forehead flap is not able to reach the nasal vestibule when the nasal skin is intact. Transecting the ala creates a shortcut route for the forehead flap to provide lining for the nasal vault, nasal floor, and soft tissue cover for the columella. A bilateral trans alar forehead flap was used to reconstruct the nasal lining and columella in a patient with a severely contracted cocaine nose. An L strut cartilage graft was covered with the forehead flaps, which were divided and inset in the nasal vault separately 3 weeks apart. The bilateral trans alar forehead flap is an excellent alternative to microsurgical reconstruction of the nasal lining and columella in the cocaine nose. Secondary thinning of a wide columella may be indicated, but the forehead skin provides a good color match. The scars on the forehead and the alar scars on the border of subunits of the nose heal well and are minor tradeoffs.
Skin Grafting Using Collagen Fiber Orientation Matching
Authors: Kuwahara Masamitsu , Osaki Shigeyoshi , Asada Hideo 
Published: January 2022

Background:
Skin contracture after skin grafting is undesirable. It is generally accepted that full-thickness skin grafts contract less than split-thickness skin grafts. However, unexpected secondary skin-graft contracture sometimes occurs after full-thickness skin grafting. We tried to elucidate the causes of skin contracture from the viewpoint of the orientation of collagen fibers to find a way to reduce skin-graft contracture.

Method:
First, we examined the collagen fiber orientation of the skin over the whole body in Sprague-Dawley rats. Next, two pieces of skin (width: 30 mm × 30 mm; thickness: ca. 2 mm) were stripped off a rat for grafting. The pieces were grafted to different sites so that the collagen fibers of the graft and surrounding skin ran parallel or perpendicular to each other. The collagen fiber orientation before and after the skin grafting was determined using Osaki’s microwave method, a mechanical method, and scanning electron microscopy.

Results:
The rat skin exhibited marked variations in collagen fiber orientation among different sites. The direction of the collagen fiber orientation corresponded to that of minimal mechanical strain. We found that the collagen fiber orientation in skin grafts remained almost unchanged after skin grafting.

Conclusions:
Mismatched collagen fiber orientation between grafts and the surrounding skin is considered to be a cause of secondary contracture after skin grafting. We propose that skin grafts that minimize the difference in collagen fiber orientation between the skin graft and the surrounding skin should be selected.
SHORT-TERM OUTCOMES AFTER INTERIM TREATMENT WITH BROLUCIZUMAB
Authors: Awh Caroline C. , Davis Emily C. , Thomas Mridul K. , Thomas Akshay S. 
Published: January 2022

Purpose:
To examine outcomes of eyes with neovascular age-related macular degeneration that were switched to brolucizumab because of an unsatisfactory response to bevacizumab, ranibizumab, and/or aflibercept and then switched back because of the presence or risk of intraocular inflammation.

Methods:
Retrospective case series of 51 eyes. Visual acuity and retinal anatomy on optical coherence tomography were recorded at the first brolucizumab injection (T1), the final brolucizumab injection (T2), and 6 months following the final brolucizumab injection (T3).

Results:
At T2, 41 eyes (41/51%, 80%) had decreased subretinal fluid (31 eyes), intraretinal fluid (12 eyes), or pigment epithelial detachment height (12 eyes). At T3, decreased subretinal fluid was sustained in 17 eyes (17/31%, 55%), decreased intraretinal fluid was sustained in eight eyes (8/12%, 67%), and decreased pigment epithelial detachment height was sustained in eight eyes (8/12%, 67%). Mean logarithm of the minimum angle of resolution visual acuity at T1, T2, and T3 was 0.396 (∼20/50), 0.441 (∼20/55), and 0.468 (∼20/59), respectively. During the brolucizumab treatment period, 11 eyes (11/51%, 22%) developed intraocular inflammation, including one case of retinal vasculitis.

Conclusion:
Interim treatment with brolucizumab resulted in anatomical improvements in 41 eyes (41/51%, 80%) that were maintained in 22 of these eyes (22/41%, 54%) for at least 6 months after switching back to the original anti–vascular endothelial growth factor therapeutic. There were no corresponding significant changes in visual acuity.
ROLE OF OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN DETECTING AND MONITORING INFLAMMATORY CHOROIDAL NEOVASCULARIZATION
Authors: Kongwattananon Wijak , Grasic David , Lin Henry , Oyeniran Enny , Sen H. Nida , Kodati Shilpa 
Published: January 2022

Purpose:
To investigate the utility of optical coherence tomography angiography (OCTA) for the detection of inflammatory choroidal neovascularization (iCNV) and monitoring their response to treatment.

Methods:
A retrospective review of patients with a diagnosis of uveitis and associated iCNV with active exudation was performed. Active iCNV was determined by spectral domain OCT and/or fluorescein angiogram. Spectral domain OCTA outer retina to choriocapillaris slabs was evaluated for the presence of iCNV. Follow-up OCTA images were qualitatively assessed to determine whether regression of iCNV occurred after treatment.

Results:
Thirteen eyes of 12 patients were included. The etiologies of uveitis include punctate inner choroidopathy (n = 4), multifocal choroiditis (n = 2), presumed sarcoid uveitis (n = 2), tuberculous choroiditis (n = 1), birdshot chorioretinopathy (n = 1), syphilitic uveitis (n = 1), serpiginous choroiditis (n = 1), and idiopathic panuveitis (n = 1). Inflammatory choroidal neovascularization was detected on en face OCTA in 10 of 13 eyes (76.9%). After iCNV treatment, en face OCTA demonstrated complete regression of iCNV in 5 of 10 eyes (50%), partial regression in 2 of 10 eyes (20%), and no regression in 3 of 10 eyes (30%).

Conclusions:
Optical coherence tomography angiography is an effective modality for detecting iCNV and could provide detailed visualization regarding location, morphologic structure, and flow of the iCNV and its response to therapy.
IOL power calculations after LASIK or PRK: Barrett True-K biometer-only calculation strategy yields equivalent outcomes as a multiple formula approach
Authors: Ferguson Tanner J. , Downes Rachel A. , Randleman J. Bradley 
Published: January 2022

Purpose:
To compare the accuracy of intraocular lens (IOL) power calculations performed using the biometer-embedded Barrett True-K formula vs a multiple formula approach using the ASCRS postrefractive calculator in eyes with previous myopic or hyperopic refractive surgery.

Setting:
Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.

Design:
Retrospective, consecutive case series.

Methods:
Patients who underwent cataract surgery with a history of corneal refractive surgery were included. For each formula, the IOL prediction error and refractive prediction error was calculated. Main outcome measures included mean absolute error (MAE) and the percentage of eyes within ±0.25 diopters (D), ±0.50 D, and ±1.00 D.

Results:
96 postmyopic eyes and 47 posthyperopic eyes were analyzed. In the postmyopic cohort, the Barrett True-K formula had the lowest MAE (0.36 D), followed by the Haigis-L formula (0.41 D). The Barrett True-K formula had a significantly higher percentage (44.8%) of eyes within ±0.25 D in comparison with the Haigis-L formula (34.4%), which had the second highest percentage (P < .01). In the posthyperopic cohort, the Barrett True-K formula had the lowest MAE (0.41 D), followed by the ASCRS–mean (0.46). The Barrett True-K and ASCRS–mean formulas had the highest percentage of eyes within ±0.25 D (42.6% vs 38.3%, P = .16).

Conclusions:
The Barrett True-K formula built into the biometer performed equivalently to a multiple formula approach on the ASCRS online calculator in both postmyopic and posthyperopic eyes. This approach reduces the potential for transcription error from data entry for lens power calculation approaches that require manual data entry.
Ocular parameter changes after phacoemulsification in pseudoexfoliative eyes: case–control study
Authors: Kassos Ioannis , Tzamalis Argyrios , Dermenoudi Maria , Matsou Artemis , Koronis Spyridon , Ziakas Nikolaos , Anastasopoulos Eleftherios 
Published: January 2022

Purpose:
To assess changes of angle morphometric parameters, anterior chamber depth (ACD), intraocular pressure (IOP), and endothelial cell density (ECD) after uneventful phacoemulsification in eyes with pseudoexfoliation syndrome (PEX) compared with those in eyes without PEX and to evaluate the effect of these changes on effective lens position and postoperative refraction.

Setting:
Papageorgiou Hospital, Thessaloniki, Greece.

Design:
Prospective case–control study.

Methods:
Angle opening distance, trabecular-iris space area, and scleral spur angle width were measured using anterior segment optical coherence tomography. ACD was assessed using IOLMaster and ECD using specular microscopy. All parameters were evaluated at baseline and 2 months postoperatively.

Results:
42 patients (42 eyes) with PEX and 39 patients (39 eyes) without PEX who underwent uneventful phacoemulsification were enrolled. All angle parameters and ACD increased significantly after phacoemulsification in both groups (P < .001), with no statistically significant difference between them (P > .05). Percentile change in ACD was greater in PEX eyes (P = .017). Regarding the mean refractive prediction error, no statistically significant differences were found between the study groups (P = .68). A statistically significant trend toward hyperopic shift was noted in the PEX group (P = .039). IOP and ECD diminished postoperatively in both groups, with no statistically significant difference between the study groups (P = .09 and P = .22, respectively).

Conclusions:
PEX, compared with non-PEX eyes, demonstrated a greater anterior chamber deepening and a hyperopic shift after phacoemulsification. These could be related to the zonular laxity in eyes with PEX and imply that PEX eyes may require a modified target refraction to achieve the desired refractive outcome.
Intrastromal corneal ring segments followed by PRK for postkeratoplasty high astigmatism: prospective study
Authors: Bertino Pedro , Magalhães Renata Soares , de Souza Carlos José , Rocha Guilherme , Santhiago Marcony R. 
Published: January 2022

Purpose:
To evaluate refractive and topographic results of the association of intrastromal corneal ring segments (ICRS) with photorefractive keratectomy (PRK) for the correction of high (>6.0 diopters [D]) postkeratoplasty astigmatism (PKA).

Setting:
University of São Paulo, São Paulo, Brazil.

Design:
Prospective interventional study.

Methods:
Postpenetrating keratoplasty patients, intolerant to contact lens fitting, and with corneal astigmatism higher than 6.0 D were treated by the combination of ICRS and PRK from January 2017 to June 2019. First, patients underwent femtosecond laser–assisted ICRS implantation to reduce and regularize corneal astigmatism, and 3 months later, submitted to PRK for the residual astigmatism. Outcomes were obtained 12 months after PRK.

Results:
The study comprised 30 eyes of 29 patients. Mean uncorrected distance visual acuity (logMAR) changed from 1.16 ± 0.37 in the preoperative to 0.69 ± 0.40 after ICRS (P < .0001) and to 0.34 ± 0.29 12 months after PRK (P < .0001). Mean spherical equivalent decreased from −5.19 ± 4.81 D in the preoperative to −3.38 ± 4.51 D after ICRS (P < .0001) and to −2.30 ± 2.84 D after PRK (P = .132). Mean topographic astigmatism decreased from 7.88 ± 2.13 D in the preoperative to 5.47 ± 2.29 D after ICRS (P < .0001) and to 4.12 ± 2.93 D after PRK (P = .003). Mean refractive astigmatism decreased from 7.10 ± 1.13 D in the preoperative to 4.61 ± 1.61 D after ICRS (P < .0001) and to 2.58 ± 1.49 D after PRK (P < .0001). After PRK, the mean correction index (CI) for corneal astigmatism was 0.77 ± 0.36. The ICRS/PRK combination resulted in a higher CI than ICRS only, both for corneal and refractive astigmatism. 2 eyes (8%) presented clinically significant opacification. Other complications were endothelial rejection (n = 1, 4%), infectious keratitis (n = 1, 4%), and ICRS extrusion after corneal melting (n = 1, 4%).

Conclusions:
The association of ICRS and PRK was effective for treating high PKA. This strategy improved visual acuity, spherical equivalent, topographic and refractive astigmatism and resulted in a high CI. Safety questions remain open and must be balanced against benefits.
Comparison of astigmatic correction with and without limbal marking during small-incision lenticule extraction
Authors: Wang Boyuan , Wang Yan , Zhang Jiamei 
Published: January 2022

Purpose:
To compare clinical outcomes after correction of moderate to high astigmatism through small-incision lenticule extraction (SMILE) with and without limbal marking.

Setting:
Tianjin Eye Hospital, Tianjin, China.

Design:
Prospective randomized comparative case series.

Methods:
This prospective randomized control study included 240 unilateral eyes of 240 patients who underwent SMILE with astigmatism of more than 0.75 diopters (D). The eyes were randomly assigned to a marked group (120 eyes) or an unmarked control group (120 eyes). Manifest refraction was observed at the 3-month follow-up timepoint and evaluated using a vector analysis.

Results:
Postoperative astigmatism differed statistically significantly in the marked group (−0.08 ± 0.15 D) and the control group (−0.16 ± 0.24 D) at 3 months (P = .001), and correction index, index of success, angle of error (absolute value), and magnitude of error were also significantly better in the marked group (P < .05). There was a significant positive correlation between index of success and angle of error (absolute value) (P < .001).

Conclusions:
Limbal marking–based manual compensation prior to SMILE was associated with a statistically significant reduction in undercorrection and error of axis in cases of moderate to high astigmatism, although the magnitude of the difference was small.
Assessing the Economics of an Entry-Level Physician Assistant Doctoral Degree
Authors: Miller Anthony A. , Coplan Bettie 
Published: January 2022

Purpose:
An entry-level doctoral degree for the physician assistant (PA) profession has been a perennial issue since the master's degree approval in 2000 and the 2009 release of the Clinical Doctorate Summit Report. Many PA counterparts have transitioned to required or optional doctoral degrees for entry into practice. Although the PA profession has not adopted an entry-level doctorate, postgraduate doctoral programs have proliferated. This study's aim was to compare the cost of post-PA doctoral degrees to the estimated cost of an entry-level PA doctorate.

Methods:
Cost of a post-PA doctoral degree was obtained from data on 15 postgraduate doctoral programs associated with PAEA member programs. Historical, aggregated data on PA program characteristics were collected from PAEA Annual Program Survey reports to estimate costs for an entry-level doctorate and to propose a likely model. For comparison, educational program data from health professions that have transitioned to entry-level doctorates were assessed.

Results:
The average cost for postgraduate PA programs is significantly higher than the projected add-on cost for an entry-level PA doctorate, which ranges from $5,731 to $15,563. Directors of post-PA doctorate programs report that enrollments are generally near or at capacity.

Conclusions:
Implementation of an entry-level doctorate by accredited PA educational programs has the potential for significant economic and chronological advantages over postgraduate doctoral programs.
Nonsquamous Lesions of the Vulvar Skin and Subcutaneous Tissue: A Review (Part 2)
Authors: Rastegar Shima , Aisner Seena C. , Heller Debra S. 
Published: January 2022

Objective
The aim of this second article was to complete part 1 review of nonsquamous lesions of the vulvar skin and subcutaneous tissue (Journal of Lower Genital Tract Disease, 2021), clinically and pathologically, based on the fifth edition of the World Health Organization tumor classification.

Materials and Methods
A database search of PubMed and Google Scholar was performed between 1970 and 2021, using the search terms “vulva,” “lower genital tract,” and “non-squamous lesions.” The search was limited to “human gynecological pathology.” Full article texts were reviewed, and reference lists were screened for additional articles. We excluded abstracts and articles written in the non-English language.

Results
An initial list of 400 articles was identified. Thirty-seven articles discussed clinicopathological features of nonsquamous lesions of the vulvar skin and subcutaneous tissue.

Conclusions
Clinicopathological features of nonsquamous lesions of the vulvar skin and subcutaneous tissue as categorized by the updated World Health Organization classification are presented.
Hypertriglyceridemia: rationale, design and implementation of the Australian Hypertriglyceridemia Registry
Authors: Pang Jing , Li Stephen C.H. , Chan Dick C. , Sullivan David R. , Woodward Ann-Marie , Watts Gerald F. 
Published: January 2022

Purpose of review
Hypertriglyceridemia (HTG) is a risk factor for atherosclerotic cardiovascular disease (ASCVD), aortic stenosis, hepatic steatosis and pancreatitis. We briefly review the aetiology and treatment of HTG and familial chylomicronemia syndrome (FCS), as well as the implementation of a clinical quality registry for improving care, the Australian Hypertriglyceridemia (AUSTRIG) Registry.

Recent findings
There is a need to improve the detection of individuals with severe HTG and FCS, who could benefit from more intense and novel treatments to prevent end-organ damage. Patient registries provide valuable data for advancing care of individuals with severe HTG at high risk of acute pancreatitis, steatohepatitis and ASCVD. However, there is a paucity of registries of such patients. We outline the design and implementation of the AUSTRIG Registry.

Summary
Clinical registries can be employed in many ways for improving outcomes for patients with HTG, through the collation and analysis of data for enabling health service planning, clinical trials and audits, and for better informing and empowering registrants.
Healthy and unhealthy aging on kidney structure and function: human studies
Authors: Denic Aleksandar , Rule Andrew D. , Glassock Richard J. 
Published: January 2022

Purpose of review
This review is intended to provide an up-to-date analysis of the structural and functional alterations of the kidneys that accompany healthy and unhealthy aging in humans. Macro- and micro- structural changes and glomerular filtration rate (whole kidney and single nephron) accompanying aging will be stressed.

Recent findings
Comparative findings concerning distribution of anatomic changes of the kidney healthy and unhealthy aging are reviewed. Challenges concerning definition of chronic kidney disease (CKD) in otherwise healthy aging patients are discussed. The complex interactions of CKD and aging are discussed. The role of podocyte dysbiosis in kidney aging is reviewed.

Summary
Kidney aging is a complex phenomenon often difficult to distinguish from CKD. Nonetheless, phenotypes of healthy and unhealthy aging are evident. Much more information concerning the molecular characteristics of normal kidney aging and its relevance to chronic kidney disease is needed.