bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for delayed intrauterine device removal among menopausal women in rural China
Authors: Zong Zhanhong , Sun Xiaoming , Hearst Norman 
Published: August 2022

Abstract

Objective
More women in China have received intrauterine devices (IUDs) than in the rest of the world combined. Recent reports have recognized a growing problem of delayed removal of these IUDs after menopause, especially in rural China, but few studies have examined women's knowledge and other risk factors for delayed removal.

Methods
A total of 1,014 perimenopausal and postmenopausal women aged 45 to 64 years participating in a pilot program providing free IUD removal in rural China completed a questionnaire. We examined their knowledge about when IUDs should be removed and other demographic and reproductive health characteristics and the association of these factors with whether their IUD removal was on time or delayed using bivariate contingency analysis and multivariate logistic regression.

Results
A total of 40.2% of women were having their IUDs removed more than 2 years after menopause, and 67.9% did not know the correct time for IUD removal. Women who were older, less educated, had one child, had their IUD placed in a rural facility, and with no gynecological examination in the past 2 years were less likely to know when an IUD should be removed. In multivariate analysis, knowledge, the facility where the IUD was placed, and a recent gynecological examination were independent predictors of on-time removal. At least 170 women had received a gynecological examination after menopause without the IUD being removed at that time.

Conclusions
Lack of knowledge about timing for IUD removal and structural barriers in health service organization must be addressed to improve care for millions of women with IUDs in rural China.
Cross-cultural adaptation and psychometric evaluation of the Brazilian Portuguese version of the Vulvovaginal Symptoms Questionnaire
Authors: Alem Michele Elisabete Rúbio , Chaves Thais Cristina , de Figueiredo Vilena Barros , Beleza Ana Carolina Sartorato , Ferreira Cristine Homsi Jorge , da Silva Jordana Barbosa , Driusso Patricia 
Published: August 2022

Abstract

Objective
The aims of this study were to perform a cross-cultural adaptation of the Vulvovaginal Symptoms Questionnaire (VSQ) into Brazilian Portuguese (VSQ-Br) and evaluate its measurement properties (structural validity, construct validity, internal consistency, and reliability).

Methods
Cross-cultural adaptation was conducted through the translation, synthesis, and back-translation of the VSQ-Br. Subsequently, 314 women completed the Pelvic Floor Impact Questionnaire, Pelvic Floor Disorders Inventory, Medical Outcomes Study 36-Item Short-Form Health Survey, and VSQ-Br. Seven to 10 days later, participants completed the VSQ-Br for the second time. Data were submitted for confirmatory factor analysis. Cronbach α was used to verify internal consistency, and construct validity was assessed using Pearson correlation coefficient (r). Reliability was calculated using the intraclass correlation coefficient.

Results
Confirmatory factor analysis showed that the questions were grouped into four domains (symptoms, emotions, life impact, and sexual impact). The model showed good fit (>0.95). The Cronbach α in this study was 0.85, reflecting adequate internal consistency. Adequate reliability was confirmed, with an intraclass correlation coefficient total score of 0.80. The VSQ-Br had a weak correlation with the pelvic domain of the Pelvic Floor Disorders Inventory, the pelvic organ prolapse domain of the Pelvic Floor Impact Questionnaire, and pain, vitality, and the social aspect domains of the Medical Outcomes Study 36-Item Short-Form Health Survey.

Conclusions
The VSQ-Br was validated and had acceptable measurement properties for assessing vulvovaginal symptoms in Brazilian women.
The American Academy of Ophthalmology IRIS Registry (Intelligent Research In Sight): current and future state of big data analytics
Authors: Pershing Suzann , Lum Flora 
Published: August 2022

Purpose of review
To describe the drivers, development, and current state of the American Academy of Ophthalmology IRIS Registry (Intelligent Research In Sight), and analytics involving deidentified aggregate IRIS Registry data.

Recent findings
The IRIS Registry has a core mission of quality improvement and reporting. In addition, analytic projects performed to date have included characterizing patient populations and diseases, incidence, and prevalence; clinical outcomes and complications; risk factors and effect modifiers; practice patterns; and trends over time. Pipeline projects include application of artificial intelligence and machine learning approaches for predictive modeling and analytics, disease mapping, detecting patterns and identifying cohorts, and optimizing treatment based on patient-specific characteristics.

Summary
The IRIS Registry is the nation's largest single specialty clinical registry, with unique data elements specific to ophthalmology. It offers a wealth of opportunities involving big data analytics, including traditional inferential statistics as well as machine learning and artificial intelligence approaches scalable on massive amounts of data.
Phakic intraocular lenses: an update and review for the treatment of myopia and myopic astigmatism in the United States
Authors: Moshirfar Majid , Webster Court R. , Ronquillo Yasmyne C. 
Published: August 2022

Purpose of review
To review all phakic intraocular lenses (pIOLs) available in the United States for the correction of myopia or myopic astigmatism and offer a clinical approach to their proper use, postoperative follow-up, and analysis of visual and adverse outcomes.

Recent findings
In March 2022, the FDA approved the EVO/EVO+ Visian ICL for widespread use, adding this lens to the two others available (Verisyse, Visian ICL). Cataract formation, endothelial cell loss (ECL) and surgical reintervention remain the most common adverse events. There are discrepancies between studies on ECL following implantation with pIOLs, although trends can be deduced with meta-analysis. Posterior Chamber-pIOLs (PC-pIOLs), especially the EVO/EVO+, have an overall lower mean adverse effect and subjective patient symptom profile when compared to Iris Fixated-pIOLS (IF-pIOLs). Advancements in PC-pIOL sizing have provided a noticeable difference in visual and safety outcomes.

Summary
All pIOLs available in the United States provide high-quality visual correction of moderate to high myopia and/or myopia with astigmatism. Proper follow-up for ECL and cataract formation is warranted.
Private equity acquisitions: physician considerations at different stages of career
Authors: Khan Mohammed Ali 
Published: August 2022

Purpose of review
To assess the impact of private equity acquisitions on physician career considerations, with particular attention to stage of career.

Recent findings
Recent studies have demonstrated a clear increase in private equity acquisitions in ophthalmology, particularly in retina-oriented practices. Survey-related publications of recent fellow graduates may provide insights regarding considerations of early career ophthalmologists, whereas commentaries from senior ophthalmologists offer insights to considerations of late career physicians. To date, no published evidence exists regarding the differential financial and/or professional effects of private equity acquisitions on ophthalmologists with regards to career stage. Such effects may differ on the specific structure, nature, and terms of the private equity acquisition.

Summary
Private equity acquisitions in ophthalmology may have several short-term, mid-term, and long-term effects on physicians over a variety of financial and career considerations. As such, there may be a differential effect of private equity acquisitions on early, mid, and late career physicians. Future outcome-related data will be necessary to fully understand the impact of private equity acquisitions on physicians both professionally and with regards to clinical care.
Artificial intelligence in dementia
Authors: Richardson Alexander , Robbins Cason B. , Wisely Clayton E. , Henao Ricardo , Grewal Dilraj S. , Fekrat Sharon 
Published: August 2022

Purpose of review
Artificial intelligence tools are being rapidly integrated into clinical environments and may soon be incorporated into dementia diagnostic paradigms. A comprehensive review of emerging trends will allow physicians and other healthcare providers to better anticipate and understand these powerful tools.

Recent findings
Machine learning models that utilize cerebral biomarkers are demonstrably effective for dementia identification and prediction; however, cerebral biomarkers are relatively expensive and not widely available. As eye images harbor several ophthalmic biomarkers that mirror the state of the brain and can be clinically observed with routine imaging, eye-based machine learning models are an emerging area, with efficacy comparable with cerebral-based machine learning models. Emerging machine learning architectures like recurrent, convolutional, and partially pretrained neural networks have proven to be promising frontiers for feature extraction and classification with ocular biomarkers.

Summary
Machine learning models that can accurately distinguish those with symptomatic Alzheimer's dementia from those with mild cognitive impairment and normal cognition as well as predict progressive disease using relatively inexpensive and accessible ocular imaging inputs are impactful tools for the diagnosis and risk stratification of Alzheimer's dementia continuum. If these machine learning models can be incorporated into clinical care, they may simplify diagnostic efforts. Recent advancements in ocular-based machine learning efforts are promising steps forward.
Anterior segment reconstruction due to cosmetic iris implants placed in the anterior chamber
Authors: Fram Nicole R. , Snyder Michael , Pineda Roberto , Miller Kevin M. , Landreneau James , van den Berg Arthur , Rocha Karolinne Maia 
Published: August 2022

A 27-year-old woman had BrightOcular iris implants placed for cosmetic purposes that changed eye color from brown to blue bilaterally. Of note, BrightOcular implants are not approved by the U.S. Food and Drug Administration (FDA) for use in the United States and have been associated with severe ocular complications. In keeping with their design, they were placed in the anterior chamber (AC) in both eyes of this patient; surgery was performed outside the United States.
As has been described previously and tragically in other cases, she developed chronic inflammation, intolerable glare, angle-closure glaucoma, corneal edema, and cataracts in both eyes. For medically unmanageable elevated intraocular pressure (IOP), she underwent diode laser cyclophotocoagulation (CPC) in both eyes, and eventually, an Ahmed tube shunt (New World Medical, Inc.) was placed in the right eye. Although she was advised and urged to have the iris implants removed, despite her ocular issues, she refused removal until intolerable glare and reduced vision ensued. Ultimately, both iris implants were extracted 5 years after implantation by a U.S. surgeon; the procedures resulted in corneal decompensation and progressive cataract development. Subsequent penetrating keratoplasty (PKP) was performed for the right eye, but it failed because of contact with the glaucoma tube shunt. She sought additional consultation and presented with the following findings: corrected distance visual acuity was 20/400 in the right eye and 20/40 in the left eye, IOP of 18 mm Hg in the right eye and 16 mm Hg in the left eye, pupils were nonreactive and fixed, and extraocular muscles and central visual field were normal. Pachymetry was 868 μm in the right eye and 653 μm in the left eye.
Anterior segment examination in the right eye revealed a failed corneal graft with 3+ edema, peripheral anterior synechiae (PAS) for 360 degrees, shallow AC, Ahmed tube shunt at the 11 o'clock position and remnant iris adherent to the graft–host junction for 270 degrees, 3+ posterior subcapsular cataract, and 2+ cortical cataract (Figure 1

JOURNAL/jcrs/04.03/02158034-202208000-00024/figure1/v/2023-08-19T002639Z/r/image-tiff

). The sclera revealed multiple circular and circumferential atrophic blue spots consistent with high-energy transscleral CPC (Figure 2

JOURNAL/jcrs/04.03/02158034-202208000-00024/figure2/v/2023-08-19T002639Z/r/image-tiff

). In the left eye, she had remnant fixed dilated iris for 270 degrees, missing iris superiorly for 3 clock hours, an adequate AC, and 2+ cortical cataract (Figure 3

JOURNAL/jcrs/04.03/02158034-202208000-00024/figure3/v/2023-08-19T002639Z/r/image-tiff

). Posterior segment examination revealed a 0.5 cup-to-disc ratio in both eyes with normal vessels, macula, vitreous, and retinal periphery, bilaterally.
Given this constellation of findings, how would you proceed?
Development and evaluation of the patient-reported outcomes measurement information system (PROMIS) pediatric pain quality item bank and short form
Authors: Mara Constance A. , Carle Adam C. , Goldschneider Kenneth R. , Kashikar-Zuck Susmita , Sherry David D. , Dampier Carlton , Morgan Esi M. 
Published: August 2022

Abstract
Pain is a common problem among children, particularly those with pediatric chronic diseases. Multifaceted assessment of pain can improve communication about pain and help clinicians characterize, differentiate, and treat a patient's unique experience of pain. Pain quality is an important domain of pain, describing the subjective sensory experiences associated with pain as well as the affective experiences of pain. The aim of the current study was to quantitatively evaluate the measurement properties of the 59 Patient-Reported Outcomes Measurement Information System pediatric pain quality candidate items developed as part of the National Institutes of Health's Patient-Reported Outcomes Measurement Information System initiative with input from children and adolescents with chronic pain. Participants included N = 448 pediatric patients between 8 and 18 years of age with chronic health conditions with a prominent component of chronic or recurrent pain, including juvenile fibromyalgia, juvenile idiopathic arthritis, and sickle cell disease. A confirmatory factor analysis revealed a unidimensional model fit the data best, with 56 of the 59 items demonstrating good psychometric properties for inclusion in the final measure. In addition, a consensus-building method was used to establish 2 versions of a short form measure—one with 8 items focused primarily on the sensory pain qualities and one with 8 items focused on affective pain qualities. The final measure shows good reliability and validity, and is recommended for use in research and clinical care with pediatric populations.
Effectiveness and Tolerability of Lurasidone for Bipolar Types I and II and Other Specified Bipolar Depression
Authors: Takaesu Yoshikazu , Takeshima Minoru , Watanabe Koichiro 
Published: August 2022

Abstract

Background
There are few guidelines on the management of depressive episodes in patients with bipolar type II (BDII) and related disorders (other specified bipolar and related disorders [OSBD]). Lurasidone is a potential option for treating depressive episodes in BDII/OSBD. This retrospective chart review study aimed to examine the effectiveness and tolerability of lurasidone for use in patients with bipolar depression.

Methods
We reviewed 66 consecutive outpatients with bipolar depression who were prescribed lurasidone between June 2020 and January 2021 and examined 12-week outcomes. Fourteen patients were diagnosed with BDI, and 52 patients were diagnosed with BDII/OSBD (42 BDII and 10 OSBD). Depressive symptoms were evaluated by the Quick Inventory of Depressive Symptomatology, Self-Report (QIDS-SR) at baseline and 2, 4, and 12 weeks. Tolerability was assessed throughout the study period by the incidence of adverse events, such as akathisia, nausea, and manic/hypomanic switch, as well as the lurasidone dropout rate due to adverse events.

Results
The total QIDS-SR score at 2 (P < 0.001), 4 (P < 0.001), and 12 weeks (P < 0.001) was significantly lower than that measured at baseline. Remission rate during study period was 29.1%. Of the 66 participants, 47 (71.2%) continued taking lurasidone and 27 (40.9%) and 16 (24.2%) reported adverse events and akathisia, respectively. No significant difference in total QIDS-SR score, dropout rate due to adverse events, rate of adverse events, or rate of akathisia was found between the BDII/OSBD and BDI groups.

Implications
Lurasidone is tolerated and could be effective for managing depressive episodes in patients with BDII/OSBD and BDI.
Clinical insights into drug-associated pancreatic injury
Authors: Barakat Monique T. , Abu-El-Haija Maisam , Husain Sohail Z. 
Published: August 2022

Purpose of review
Drug-induced pancreatitis is one of the top three causes of acute pancreatitis. A drug exposure is traditionally determined to be the cause of pancreatitis only after other possible and common causes of pancreatitis have been excluded.

Recent findings
In this review, we challenge this traditional notion of drug-induced pancreatitis as a diagnosis of exclusion. Instead, we propose to shift the paradigm of conceptualizing what we term drug-associated pancreatic injury (DAPI); as a continuum of pancreatic injury that can be concomitant with other risk factors. The aims of this targeted review are to harness recent literature to build a foundation for conceptualizing DAPI, to highlight specific drugs associated with DAPI, and to describe a framework for future studies of DAPI.

Summary
Our hope is that probing and characterizing the mechanisms underlying the various types of DAPI will lead to safer use of the DAPI-inducing drugs by minimizing the adverse event of pancreatitis.
Recent advances in factor XII structure and function
Authors: Shamanaev Aleksandr , Litvak Maxim , Gailani David 
Published: August 2022

Purpose of review
Factor XII (FXII), the precursor of the protease FXIIa, contributes to pathologic processes including angioedema and thrombosis. Here, we review recent work on structure-function relationships for FXII based on studies using recombinant FXII variants.

Recent findings
FXII is a homolog of pro-hepatocyte growth factor activator (Pro-HGFA). We prepared FXII in which domains are replaced by corresponding parts of Pro-HGA, and tested them in FXII activation and activity assays. In solution, FXII and prekallikrein undergo reciprocal activation to FXIIa and kallikrein. The rate of this process is restricted by the FXII fibronectin type-2 and kringle domains. Pro-HGA replacements for these domains accelerate FXII and prekallikrein activation. When FXII and prekallikrein bind to negatively charged surfaces, reciprocal activation is enhanced. The FXII EGF1 domain is required for surface binding.

Summary
We propose a model in which FXII is normally maintained in a closed conformation resistant to activation by intramolecular interactions involving the fibronectin type-2 and kringle domains. These interactions are disrupted when FXII binds to a surface through EGF1, enhancing FXII activation and prekallikrein activation by FXIIa. These observations have important implications for understanding the contributions of FXII to disease, and for developing therapies to treat thrombo-inflammatory disorders.
Concurrent Cervical and Anal High-Risk Human Papillomavirus Infection in Women Living With HIV: An Observational Case–Control Study
Authors: Gupta Ruchika , Hussain Showket , Hariprasad Roopa , Dhanasekaran Kavitha , Verma Sheel , Agarwal Vineeta , Das Pradeep K. , Singh Sompal , Gupta Sanjay 
Published: August 2022

Background:
To evaluate the prevalence and correlates of concurrent uterine cervical and anal HR-HPV infections in women living with HIV (WLHIV).

Setting:
A cross-sectional study was undertaken at a tertiary care hospital and linked ART center.

Methods:
One hundred and forty-one WLHIV and 161 HIV-negative women were enrolled for cervical and anal cytology as well as HR-HPV testing using the HC2 method. Screen-positive women were followed-up with colposcopy/anoscopy and/or repeat cytology. Appropriate statistical tests were applied to assess the association of concurrent HR-HPV with various parameters.

Results:
Concurrent cervical and anal HR-HPV infection was detected in 22 WLHIV (16.3%) and 5 HIV-negative women (3.1%), the difference being statistically significant (P < 0.001). Among WLHIV, concurrent HR-HPV was associated with tobacco use (P < 0.001), receptive anal intercourse (P = 0.02), low CD4 counts (P = 0.001), and negatively with ART intake (P = 0.004) on bivariate analysis. Multivariate logistic regression analysis showed a positive association of concurrent HR-HPV positivity with tobacco use (P = 0.02) and low nadir CD4 counts (P = 0.03).

Conclusions:
WLHIV, especially those with CD4 counts less than 200/µL, should be offered HR-HPV screening and follow-up to detect cervical and anal lesions.
A Gene Expression Signature to Select Hepatocellular Carcinoma Patients for Liver Transplantation
Authors: Pinto-Marques Hugo , Cardoso Joana , Silva Sílvia , Neto João L. , Gonçalves-Reis Maria , Proença Daniela , Mesquita Marta , Manso André , Carapeta Sara , Sobral Mafalda , Figueiredo Antonio , Rodrigues Clara , Milheiro Adelaide , Carvalho Ana , Perdigoto Rui , Barroso Eduardo , Pereira-Leal José B. 
Published: August 2022

Objective:
To propose a new decision algorithm combining biomarkers measured in a tumor biopsy with clinical variables, to predict recurrence after liver transplantation (LT).

Background:
Liver cancer is one of the most frequent causes of cancer-related mortality. LT is the best treatment for hepatocellular carcinoma (HCC) patients but the scarcity of organs makes patient selection a critical step. In addition, clinical criteria widely applied in patient eligibility decisions miss potentially curable patients while selecting patients that relapse after transplantation.

Methods:
A literature systematic review singled out candidate biomarkers whose RNA levels were assessed by quantitative PCR in tumor tissue from 138 HCC patients submitted to LT (>5 years follow up, 32% beyond Milan criteria). The resulting 4 gene signature was combined with clinical variables to develop a decision algorithm using machine learning approaches. The method was named HepatoPredict.

Results:
HepatoPredict identifies 99% disease-free patients (>5 year) from a retrospective cohort, including many outside clinical criteria (16%–24%), thus reducing the false negative rate. This increased sensitivity is accompanied by an increased positive predictive value (88.5%–94.4%) without any loss of long-term overall survival or recurrence rates for patients deemed eligible by HepatoPredict; those deemed ineligible display marked reduction of survival and increased recurrence in the short and long term.

Conclusions:
HepatoPredict outperforms conventional clinical-pathologic selection criteria (Milan, UCSF), providing superior prognostic information. Accurately identifying which patients most likely benefit from LT enables an objective stratification of waiting lists and information-based allocation of optimal versus suboptimal organs.