bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute-onset postoperative endophthalmitis after cataract surgery performed by resident and attending physicians at a university teaching hospital
Authors: Kunkler Anne L. , Sengillo Jesse D. , Al-Khersan Hasenin , Fan Kenneth C. , Laura Diana M. , Miller Darlene , Donaldson Kendall E. , Yoo Sonia H. , Yannuzzi Nicolas A. , Sridhar Jayanth , Gedde Steven J. , Smiddy William E. , Flynn Harry W. 
Published: June 2022

Purpose:
To evaluate acute-onset postoperative endophthalmitis following cataract surgery and to compare rates between resident and attending physician-performed cohorts.

Setting:
Bascom Palmer Eye Institute, Miami, Florida.

Design:
Retrospective chart review.

Methods:
Records of patients diagnosed with endophthalmitis within 6 weeks of surgery performed by attending and resident physicians between January 1, 2015, and December 31, 2020, were reviewed. Total cataract volume was obtained from institutional records, and resident case totals were obtained from case logs. Endophthalmitis cases were obtained from billing records and confirmed with chart review.

Results:
There were 22 cases of endophthalmitis among 32 505 cases (0.068%). Endophthalmitis occurred in 6 of 6447 (0.093%) resident cases and 16 of 26 058 (0.061%) attending cases (P = .55). The most common bacterial isolates were coagulase-negative Staphylococcus (8/22, 36.3%) and Streptococcus species (3/22, 13.6%), with negative cultures in 10 (10/22, 45.5%). Initial treatment with vitreous tap and injection of intravitreal antibiotics was performed in 21 eyes (21/22, 95.4%) and vitrectomy with intravitreal antibiotic injection in one (1/22, 4.5%). Vitrectomy was performed secondarily in 9 patients (9/22, 40.9%). Corrected distance visual acuity (CDVA) at last follow-up was ≥20/40 in 13 eyes (13/22, 59%) and ≤hand motions in 3 eyes (3/22, 13.6%). CDVA (logMAR mean ± SD) was 1.22 ± 1.16 in resident and 0.49 ± 0.79 in attending cases (P = .11).

Conclusions:
In the current study, acute-onset postoperative endophthalmitis developed infrequently following cataract surgery. The rates and visual outcomes of endophthalmitis were similar in resident and attending cases.
Dermoscopic Assessment of Lymphangioma Circumscriptum Treated With Topical Sirolimus Ointment: A Case Report
Authors: Ankad Balachandra Suryakant , Smitha Sankappanavara Veeranna , Nagur Sushila 
Published: June 2022

Introduction:
Lymphangioma circumscriptum (LC) is characterized by malformation of superficial lymphatics. Dermoscopy reveals brownish-yellow lacunae and white septa. In scrotal LC, gray and red areas are also noted. Treatment of LC is challenging because of its high recurrence.
We herein report a case of scrotal LC that was successfully treated with topical sirolimus with dermoscopic assessment of the therapeutic response.

Case presentation:
A male patient presented with fluid-filled lesions on the scrotum after partial penectomy. Examination revealed multiple skin-colored vesicles containing serous fluid on either side of the scrotum. Dermoscopy showed brownish-yellow lacunae with white septa as specific patterns. A diagnosis of secondary LC was made based on the clinical and dermoscopic features, and the patient was treated with 0.1% topical sirolimus ointment.

Discussion:
Management of LC includes close follow-up. Sirolimus, by inhibiting cellular proliferation and angiogenesis, helps in the regression of vesicular lesions of LC. Furthermore, dermoscopy supports an accurate evaluation of the therapeutic response.

Conclusion:
Sirolimus is a promising topical agent in the treatment of LC. Dermoscopy comes handy in the evaluation of treatment response. Any residual lesions could be noted and treated accordingly.
Photoprotection Knowledge and Photoprotective Behavior of University Students: A Cross-sectional Study in Indonesia
Authors: Roren Regina Stefani , Mario Christopher Paulus , Novia Jayadi Nana 
Published: June 2022

Objective:
Awareness regarding the negative effects of ultraviolet radiation are commonly neglected in Asian countries. This study sought to evaluate the ultraviolet radiation knowledge and photoprotective behaviors of university students in Indonesia.

Methods:
This observational cross-sectional was conducted at Pelita Harapan University, Indonesia.

Results:
A total of 89 (45.4%) medical students and 107 (54.6%) nonmedical students participated in this study. Their mean age was 21.03 ± 2.03 years, and 46.4% of them had Fitzpatrick type III skin. Medical students as well as older students exhibited a higher level of knowledge regarding photoprotection (P ≤ 0.05). Factors related to good photoprotective behaviors were sex, older age, and average expenditure on skincare. Further analysis revealed that a high level of knowledge regarding photoprotection was related to acceptable photoprotective behaviors (P = 0.01; odds ratio = 1.97; 95% confidence interval = 1.13–3.54).

Conclusions:
Knowledge regarding sun-related damage and practice of photoprotective behaviors were low among the participants. The results indicate that formal education and academic subjects should incorporate the topic of sun-related damage and promote the practice of photoprotective behaviors early on to increase awareness among populations.
Management of hypertension in advanced kidney disease
Authors: Georgianos Panagiotis I. , Agarwal Rajiv 
Published: June 2022

Purpose of review
The aim of this study was to present recent developments in pharmacotherapy of hypertension in patients with advanced chronic kidney disease (CKD).

Recent findings
In the AMBER trial, compared with placebo, the potassium-binder patiromer mitigated the risk of hyperkalaemia and enabled more patients with uncontrolled resistant hypertension and stage 3b/4 CKD to tolerate and continue spironolactone treatment; add-on therapy with spironolactone provoked a clinically meaningful reduction of 11–12 mmHg in unattended automated office SBP over 12 weeks of follow-up. In the BLOCK-CKD trial, the investigational nonsteroidal mineralocorticoid-receptor-antagonist (MRA) KBP-5074 lowered office SBP by 7–10 mmHg relative to placebo at 84 days with a minimal risk of hyperkalaemia in patients with advanced CKD and uncontrolled hypertension. The CLICK trial showed that the thiazide-like diuretic chlorthalidone provoked a placebo-subtracted reduction of 10.5 mmHg in 24-h ambulatory SBP at 12 weeks in patients with stage 4 CKD and poorly controlled hypertension.

Summary
Enablement of more persistent spironolactone use with newer potassium-binding agents, the clinical development of novel nonsteroidal MRAs with a more favourable benefit-risk profile and the recently proven blood pressure lowering action of chlorthalidone are three therapeutic opportunities for more effective management of hypertension in high-risk patients with advanced CKD.
Physical Activity After Transient Ischemic Attack or Mild Stroke Is Business as Usual
Authors: Sammut Maria , Haracz Kirsti , Shakespeare David , English Coralie , Crowfoot Gary , Fini Natalie , Nilsson Michael , Janssen Heidi 
Published: June 2022

Background and Purpose:
Regular, sustained moderate-to-vigorous physical activity (MVPA) is a recommended strategy to reduce the risk of recurrent stroke for people who have had transient ischemic attack (TIA) or mild stroke. This study aimed to explore attitudes toward, and experience of engaging in physical activity by adults following a TIA or mild stroke.

Methods:
Constructivist grounded theory methodology informed data collection and analysis. Interviews from 33 adults with TIA or mild stroke (mean age 65 [SD 10] years, 48% female, 40% TIA) were collected.

Results:

Business as usual characterized physical activity engagement post-TIA or mild stroke. Most participants returned to prestroke habits, as either regular exerciser or nonexerciser, with only a small number making changes. Influencing factors for physical activity participation included information, challenges, strategies, and support. Business as usual was associated with a perceived lack of information to suggest a need to change behaviors. Nonexercisers and those who decreased physical activity emphasized challenges to physical activity, while regular exercisers and those who increased physical activity focused on strategies and support that enabled participation despite challenges.

Discussion and Conclusion:
Information about the necessity to engage in recommended physical activity levels requires tailoring to the needs of the people with TIA or mild stroke. Helpful information in combination with support and strategies may guide how to navigate factors preventing engagement and might influence the low level of physical activity prevalent in this population.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A376).
Pediatric Return Visits to the Emergency Department
Authors: Ramgopal Sriram , Varma Selina , Victor Timothy W. , McCarthy Danielle M. , Rising Kristin L. 
Published: June 2022

Objective
Although 72-hour return visits are a frequently reported metric for pediatric patients discharged from the emergency department (ED), the basis for this metric is not established. Our objective was to statistically derive a cutoff time point for the characterization of pediatric return visits.

Methods
We performed a retrospective cohort study using data of patients discharged from any of 44 pediatric EDs. We selected the first encounter per patient from January 1 to December 31, 2019, as the index encounter and included the first return visit within 30 days. We constructed a cumulative hazard curve to characterize the timing of return visits and constructed a multivariable adaptive regression spline model to identify a hinge point in return visit presentations. We identified the association between admission for early return visits and admission for late return visits using generalized linear mixed modeling.

Results
Of 1,986,778 index ED discharges, 193,605 (9.7%) ED return visits were included. A double-exponential decay model demonstrated superior fit compared with a single exponential model (P < 0.0001). Multivariable adaptive regression spline modeling identified a hinge at 7 days. When comparing proportions of return visits leading to hospitalization between early (23.8%) and late (15.1%) return visits, early visits (≤7 days) had higher adjusted odds of hospital admission (adjusted odds ratio, 1.73; 95% confidence interval, 1.69–1.77) relative to late return visits (>7 days). Findings were similar in sensitivity analyses within age subgroups, Census region, and in which the diagnosis (using the Diagnosis and Grouping System) was the same between the index and return visit. Among return visits that occurred within 7 days of the index visit, 46.3% had the same diagnosis grouping in both visits.

Conclusions
An empirically derived 7-day cutoff may be more appropriate for characterization of pediatric return visits to the ED. Encounters after this period had lower adjusted odds of admission.
Long-Term Follow-Up into Adulthood of Pediatric-Onset Primary Sclerosing Cholangitis and Autoimmune Sclerosing Cholangitis
Authors: Hercun Julian , Willems Philippe , Bilodeau Marc , Vincent Catherine , Alvarez Fernando 
Published: June 2022

Objectives:
Studies on pediatric patients with primary sclerosing cholangitis (PSC) have been limited by short follow-up and inconsistent classification of pediatric patients with autoimmune hepatitis-sclerosing cholangitis overlap (AIC). We conducted a retrospective study of patients diagnosed with AIC or PSC during childhood with extension of follow-up into adulthood.

Methods:
We reviewed records of patients followed for PSC or AIC between 1998 and 2019 at a pediatric referral center. Features at diagnosis, biochemical and liver-related outcomes (cholangitis, liver transplant, and cirrhosis) were compared.

Results:
Forty patients (27 PSC, 13 AIC) were followed for 92 months on average (standard deviation 79 months) with extension into adulthood in 52.5%; 70% had associated inflammatory bowel disease (IBD). The proportion of patients with significant fibrosis and abnormal baseline liver tests (serum bilirubin and transaminase levels) were similar in both groups. One year postdiagnosis, 55% (15/27) of PSC patients had normal liver tests versus only 15% (2/13) in the AIC group (P = 0.02). During follow-up, more liver-related events occurred in the AIC group (69% versus 27%, hazard ratio [HR] = 3.7 [95% confidence interval (CI): 1.4–10] P = 0.01). Baseline elevated serum bilirubin levels (HR = 5.3 [95% CI: 1.7–16.9] P = 0.005) and elevated transaminase levels at 1 year (HR = 9.09 [95% CI: 1.18–66.7) P = 0.03) were predictive of liver-related events, while having IBD was not (HR = 0.48 (95% CI: 0.15–1.5) P = 0.22).

Conclusions:
Pediatric patients with AIC and PSC presented at a similar fibrosis stage, however, with a more severe hepatitis in AIC. In this cohort, AIC was associated with more liver-related events, primarily driven by a higher rate of cirrhosis compared with PSC; transplant rates were similar.
Switching from tenofovir alafenamide to tenofovir disoproxil fumarate improves lipid profile and protects from weight gain
Authors: Kauppinen Kai Juhani , Aho Inka , Sutinen Jussi 
Published: June 2022

Background:
Switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) increases low-density lipoprotein cholesterol (LDL-C) and body weight. Metabolic effects of the opposite TAF-to-TDF switch are unknown.

Objectives:
To investigate the effect of TAF-to-TDF switch on plasma lipids, body weight, and atherosclerotic cardiovascular disease (ASCVD) risk score.

Design:
A retrospective chart review.

Methods:
One hundred and forty-six patients with TAF-to-TDF switch (Switch group) were compared with 146 patients matched for sex, age, and third antiretroviral agent class who continued unchanged TAF-containing regimen (Control group). Data were collected at approximately 1 year (follow-up FU-1) and 2 years (follow-up FU-2) after baseline values.

Results:
In Switch group at FU-1, total cholesterol (TC) and LDL-C decreased 12.1% and 12.4% (P < 0.001 in both), respectively. High-density lipoprotein cholesterol (HDL-C) also decreased 8.2% (P < 0.001) in Switch group, but TC/HDL-C ratio did not change. No statistically significant changes were observed in Control group in any lipid values. TC remained similarly decreased through FU-2 in Switch group, but LDL-C increased from FU-1 to FU-2 in both groups. ASCVD risk score decreased from 6.3% at baseline to 6.0% at FU-2 (P = 0.012) in Switch group but increased from 8.4 to 9.1% (P = 0.162) in Control group. Body weight increased from 83.4 kg at baseline to 84.9 kg at FU-2 (P = 0.025) in Control group but remained stable in Switch group (83.1−83.7 kg, P = 0.978).

Conclusions:
TAF-to-TDF switch improved plasma lipid profile and ASCVD risk score, as well as prevented weight gain, when compared with ongoing TAF-based antiretroviral therapy.
A retrospective real-world observational pilot analysis of Waya: a self-monitoring fitness app in Germany
Authors: Balakrishnan Preetha , Owen Elizabeth , Eberl Markus , Friedrich Benjamin , Etter Tobias 
Published: June 2022

Background
The increasing prevalence of lifestyle-driven metabolic disorders poses a heavy burden on the healthcare system. Several low-cost, easily accessible, and effective weight loss interventions are being developed to improve this situation. Waya is one such German digital application that guides users to reach their desired weight in a healthy manner, by monitoring their eating habits and physical activity levels. In this retrospective real-world observational pilot study, we aimed to identify if the use of Waya helps in reducing weight as intended and the underlying factors associated with it.

Methods
Data from healthy overweight or obese participants who provided their weight information and answered the short form of the Weight Efficacy Lifestyle Questionnaire and the International Physical Activity Questionnaire activity questionnaires once before the completion of the first module (baseline) were compared with data provided after the beginning of the last module. Age and sex-based distribution were studied and the correlation between nutrition, physical activity, and weight was analyzed.

Results
Waya participants showed an improvement in nutritional behavior, physical activity levels, and weight reduction compared with baseline. These changes were independent of age and sex. Weight loss mainly correlated with improvements in nutritional behavior but not physical activity.

Conclusion
The results from our pilot study showed that Waya is beneficial in bringing about short-term weight loss mainly through behavioral changes in nutrition. Although physical activity levels improved, its influence on weight loss was not apparent.
An Automated Method for the Assessment of Memory and Learning in Larval Zebrafish
Authors: Widder Mark , Carbaugh Chance , van der Schalie William , Li Yuanzhang , Martin Monica , Pybus Brandon , Lee Patricia , Lanteri Charlotte 
Published: June 2022

AbstractZebrafish have shown value in translational research for many human diseases, including neuropsychiatric disorders and cognitive dysfunction, with low cost and rapid testing facilitating drug screening and discovery. However, some endpoints, such as associative learning and long-term memory, have relied historically on manual data tracking that slows data acquisition and increases costs. We automated an associative learning/long-term memory test developed by Hinz et al.1 using a Noldus DanioVision system and EthoVision software to enhance assay throughput and utility for monitoring learning and memory behavior through automated tracking of location and movement of individual fish.
Reduced emergent character of neural dynamics in patients with a disrupted connectome
Authors: Luppi Andrea I. , Mediano Pedro A.M. , Rosas Fernando E. , Allanson Judith , Pickard John D. , Williams Guy B. , Craig Michael M. , Finoia Paola , Peattie Alexander R.D. , Coppola Peter , Menon David K. , Bor Daniel , Stamatakis Emmanuel A. 
Published: June 2022

AbstractHigh-level brain functions are widely believed to emerge from the orchestrated activity of multiple neural systems. However, lacking a formal definition and practical quantification of emergence for experimental data, neuroscientists have been unable to empirically test this long-standing conjecture. Here we investigate this fundamental question by leveraging a recently proposed framework known as “Integrated Information Decomposition,” which establishes a principled information-theoretic approach to operationalise and quantify emergence in dynamical systems — including the human brain. By analysing functional MRI data, our results show that the emergent and hierarchical character of neural dynamics is significantly diminished in chronically unresponsive patients suffering from severe brain injury. At a functional level, we demonstrate that emergence capacity is positively correlated with the extent of hierarchical organisation in brain activity. Furthermore, by combining computational approaches from network control theory and whole-brain biophysical modelling, we show that the reduced capacity for emergent and hierarchical dynamics in severely brain-injured patients can be mechanistically explained by disruptions in the patients’ structural connectome. Overall, our results suggest that chronic unresponsiveness resulting from severe brain injury may be due to structural impairment of the fundamental neural infrastructures required for brain dynamics to support emergence.
Integrating Conformational Dynamics and Perturbation-Based Network Modeling for Mutational Profiling of Binding and Allostery in the SARS-CoV-2 Spike Variant Complexes with Antibodies: Balancing Local and Global Determinants of Mutational Escape Mechanisms
Authors: Verkhivker Gennady , Agajanian Steve , Kassab Ryan , Krishnan Keerthi 
Published: June 2022

AbstractIn this study, we combined all-atom MD simulations, the ensemble-based mutational scanning of protein stability and binding, and perturbation-based network profiling of allosteric interactions in the SARS-Cov-2 Spike complexes with a panel of cross-reactive and ultra-potent single antibodies (B1-182.1 and A23-58.1) as well as antibody combinations (A19-61.1/B1-182.1 and A19-46.1/B1-182.1). Using this approach, we quantify local and global effects of mutations in the complexes, identify structural stability centers, characterize binding energy hotspots and predict the allosteric control points of long-range interactions and communications. Conformational dynamics and distance fluctuation analysis revealed the antibody-specific structural stability signatures of the spike complexes that can dictate the pattern of mutational escape. By employing an integrated analysis of conformational dynamics and binding energetics, we found that the potent antibodies that efficiently neutralize Omicron spike variant can form the dominant binding energy hotpots with the conserved stability centers in which mutations may be restricted by the requirements of the folding stability and binding to the host receptor. The results show that protein stability and binding energetics of the SARS-CoV-2 spike complexes with the panel of cross-reactive ultrapotent antibodies are tolerant to the constellation of Omicron mutations. A network-based perturbation approach for mutational profiling of allosteric residues potentials revealed how antibody binding can modulate allosteric interactions and identified allosteric control points that can form vulnerable sites for mutational escape. This study suggested a mechanism in which the pattern of specific escape mutants for ultrapotent antibodies may not be solely determined by the binding interaction changes but are driven by a complex balance and tradeoffs between different local and global factors including the impact of mutations on structural stability, binding strength, long-range interactions and fidelity of allosteric signaling.
Host genetics maps to behaviour and brain structure in mice
Authors: Asbury Sarah , Lai Jonathan K.Y. , Rilett Kelly C. , Haqqee Zeeshan , Darwin Benjamin C. , Ellegood Jacob , Lerch Jason P. , Foster Jane A. 
Published: June 2022

AbstractGene-environment interactions in the postnatal period have a long-term impact on neurodevelopment. To effectively model neurodevelopment in the mouse, we incorporated several validated behavioural tests to develop a behavioural pipeline that measures translationally relevant milestones of development in mice. The behavioral phenotype of 1060 wild type and genetically-modified mice was examined in parallel with structural brain imaging. The influence of genetics, sex, and early life stress on behaviour and neuroanatomy was determined using traditional statistical and machine learning methods. The results demonstrated that neuroanatomical diversity was primarily associated with genotype whereas behavioural phenotypic diversity was observed to be more susceptible to gene-environment interactions.