bluuebunny/crossref_metadata_2025_split huggingface dataset:
LONG-TERM EFFICACY OF FLUOCINOLONE IN EYES WITH IRIS–LENS DIAPHRAGM DISRUPTION AND PCME WITH MEDICATION FIXED IN THE SCLERA (MEFISTO)
Authors: Herold Tina R. , Vounotrypidis Efstathios , Liegl Raffael , Koenig Susanna F. , Priglinger Siegfried G. , Wolf Armin 
Published: March 2022

Purpose:
The aim of our prospective off-label, interventional clinical trial was to evaluate the efficacy and safety of the fluocinolone-loop-anchoring technique over two years in eyes with iris–lens diaphragm disruption and pseudophakic cystoid macular edema.

Methods:
In 10 eyes, scleral fixation of fluocinolone implant was performed. Main outcome measures were the development of best-corrected visual acuity (BCVA), central retinal thickness over 24 months, and general safety of the procedure.

Results:
A significant improvement to 0.57 ± 0.38 log MAR (Snellen 20/80) (range 0–1.30) was observed (P = 0.003) at 1 month. Further improvement to 0.45 ± 036 log MAR (Snellen 20/60) was observed until month 18 (P = 0.081). Mean central retinal thickness decreased by 22% from 601.6 ± 235.5 µm to 449.1 ± 128.9 µm at 1 month. In one patient, the implant has to be removed at Month 7 because of elevated intraocular pressure and one patient after globe rupture had a retinal redetachment at Month 4.

Conclusion:
In this study, we showed that the treatment of recalcitrant pseudophakic cystoid macular edema with scleral fixated fluocinolone implant in eyes with disruption of the iris–lens diaphragm provides good anatomical and functional results with a reasonable safety profile over 24 months in eyes where pseudophakic cystoid macular edema is otherwise difficult to treat and often left untreated.
OCT-Angiography Face Mask–Associated Artifacts During the COVID-19 Pandemic
Authors: El-Nimri Nevin W. , Micheletti Eleonora , Mohammadzadeh Vahid , Nishida Takashi , Kamalipour Alireza , Zangwill Linda M. , Bowd Christopher , Moghimi Sasan , Weinreb Robert N. 
Published: March 2022

Précis:
Face mask wearing has no significant effects on artifacts or vessel density measurements in optic nerve head (ONH) and macular optical coherence tomography-angiography (OCT-A) scans.

Purpose:
The aim was to assess the difference in area of artifacts observed in optical OCT-A scans with and without face mask wear and to verify if mask wear interferes with OCT-A vessel density measurements.

Subjects and Controls:
A total of 64 eyes of 10 healthy subjects, 4 ocular hypertensive, 8 glaucoma suspects, and 17 glaucoma patients were included.

Materials and Methods:
High-density ONH and macula OCT-A scans were obtained in patients with and without surgical masks. Seven different artifacts (motion, decentration, defocus, shadow, segmentation failure, blink, and Z-offset) were quantitatively evaluated by 2 trained graders. The changes in the area (% of scan area) of artifacts, without and with mask wearing, and differences of vessel density were evaluated.

Results:
Trends of increasing motion artifact area for the ONH scans [4.23 (−0.52, 8.98) %, P=0.08] and defocus artifact area for the macular scans [1.06 (−0.14, 2.26) %, P=0.08] were found with face mask wear. However, there were no significant differences in the mean % area of any artifacts (P>0.05 for all). Further, the estimated mean difference in vessel density in images acquired without and with masks was not significant for any type of artifact.

Conclusion:
Face mask wearing had no significant effect on area of artifacts or vessel density measurements. OCT-A vessel density measurements can be acquired reliably with face mask wear during the pandemic.
SARS-CoV-2 IgG Seroprevalence Detected by Chemiluminescence Immunoassay Among Healthcare Personnel and Patients in a Province With a Low Incidence Rate of COVID-19 During the First Wave of COVID-19 in Thailand
Authors: Patamatamkul Samadhi , Rawangban Pratya , Prommongkol Bhurapol , Potongcamphan Maythinee 
Published: March 2022

Background
There is limited evidence regarding seroprevalence during the first wave of COVID-19 in Thailand. The limited capacity of molecular laboratories in distant provinces may have resulted in fewer confirmed COVID-19 cases and possible undetected ongoing transmission, as suggested by a previously published seroprevalence study.

Objectives
This study aimed to assess the SARS-CoV-2 IgG and IgM seroprevalence among healthcare personnel and patients in Suddhavej Hospital and cross-reactivity of SARS-CoV-2 antibody assays with infectious and autoimmune diseases.

Methods
We conducted a cross-sectional study to determine seroprevalence among healthcare personnel and patients in Suddhavej Hospital, a secondary care hospital in Mahasarakham Province (population of 974,534 as of 2015). A chemiluminescence assay was used to test for IgG and/or IgM SARS-CoV-2 antibodies.

Results
The study included 112 healthcare personnel and 78 patients with a median age of 29 years (interquartile range, 25–40 years); 35.8% were male. The study found an IgG seroprevalence of 3 of 190 (1.6%; 95% confidence interval, 0.3%–4.5%). The 3 IgG-positive cases recalled possible exposure risk to COVID-19 infection outside the province. One case had a persistent elevated IgG level after 10 months of follow-up. No cross-reactivity was found among patients with a variety of infectious or immunologic diseases.

Conclusions
Our study suggests that there is a low seroprevalence among high-risk exposure groups. This evidence supports that the preventive measures used during the first wave of COVID-19 were effective in preventing asymptomatic transmission in a remote province with a low COVID-19 incidence rate.
Drug–drug–gene interaction risk among opioid users in the U.S. Department of Veterans Affairs
Authors: Chanfreau-Coffinier Catherine , Tuteja Sony , Hull Leland E. , MacDonald Sally , Efimova Olga , Bates Jill , Voora Deepak , Oslin David W. , DuVall Scott L. , Lynch Julie A. 
Published: March 2022

Abstract
Response to analgesic therapy is influenced by several factors including genetics and drug–drug interactions. Pharmacogenetic (PGx) variants in the CYP2D6 gene modify response to opioids by altering drug metabolism. We sought to determine the potential impact of PGx testing on the care of Veterans with noncancer pain prescribed opioids metabolized by CYP2D6 (codeine, hydrocodone, or tramadol). A retrospective analysis was performed within the Veterans Health Administration evaluating prescription records for pain medications metabolized by CYP2D6 and interacting drugs from 2012 to 2017. Among 2,436,654 Veterans Health Administration pharmacy users with at least 1 opioid prescription, 34% met the definition of chronic use (longer than 90 days with more than 10 prescriptions or 120 days-supply). Opioids were commonly coprescribed with antidepressants interacting with CYP2D6 (28%). An estimated 21.6% (n = 526,905) of these patients are at an elevated risk of an undesirable response to their opioid medication based on predicted phenotypes and drug–drug interactions: 3.5% are predicted CYP2D6 ultrarapid metabolizers and at increased risk for toxicity, 5.4% are poor metabolizers at higher risk for nonresponse, and 12.8% are normal or intermediate metabolizers coprescribed a CYP2D6 inhibitor leading to phenoconversion into poor metabolizer. Despite the high rate of coprescription of opioids and interacting drugs, CYP2D6 testing was infrequent in the sample (0.02%), and chart review suggests that test results were used to optimize antidepressant treatments rather than pain medications. Using PGx testing combined with consideration of phenoconversion may allow for an enhanced precision medicine approach to pain management in Veterans.
Stent Evaluation for Expiratory Central Airway Collapse
Authors: Majid Adnan , Ospina-Delgado Daniel , Ayala Alvaro , Gangadharan Sidhu P. , Alape Daniel , Buitrago Daniel , Parikh Mihir S. , Wilson Jennifer L. , Chee Alex C. , Fernandez-Bussy Sebastian , Herth Felix J.F. , Kheir Fayez 
Published: March 2022

Background:
Careful selection of patients with expiratory central airway collapse (ECAC) that may benefit from tracheobronchoplasty (TBP) can be aided by a short-term airway stent evaluation. This can be performed with either silicone Y-stents (SYSs) or uncovered self-expanding metallic airway-stents (USEMAS). No direct comparison has been made between these 2 stent types.

Methods:
This was a small retrospective review of consecutive patients that underwent a stent evaluation. A propensity score was used to match patients in the USEMAS and SYS groups. Outcomes included complications, changes in the health-related quality-of-life (HR-QoL), and changes in exercise capacity. Baseline measurements were compared with those obtained during stent evaluation and after TBP.

Results:
Forty-two patients with severe ECAC underwent USEMAS placement, while 18 patients had an SYS placed. Propensity score matching resulted in 13 matched SYS and USEMAS pairs. The SYS group had an increased rate of mucus plugging (38.5% vs. 0%, P<0.047). Although not statically significant, a clinical improvement was observed in HR-QoL and exercise capacity in the USEMAS group during stent placement. In patients who underwent TBP, both USEMAS and SYS groups had a statistically significant change in the Modified Medical Research Council Dyspnea Scale during stent evaluation and after TBP.

Conclusion:
In patients with severe ECAC, short-term evaluation with airway stents appears to be safe and improves respiratory symptoms, HR-QoL, and exercise capacity. The use of USEMAS led to a lower complication rate, a greater improvement in HR-QoL and exercise capacity, and appeared to better predict how the patients would respond to TBP.
Expression of Proteinase-activated Receptor 2 (PAR2) as a Correlate of Concern in Triple-negative Breast Cancer (TNBC)
Authors: Kapatia Gargi , Kaur Subhpreet , Kumar Sandeep , Laroiya Ishita , Singh Gurpreet , Sharma Maryada , Bal Amanjit , Luthra-Guptasarma Manni 
Published: March 2022

Purpose:
Triple-negative breast cancer (TNBC), a highly aggressive cancer with poor outcome and lacking specific diagnostic, prognostic, or targeted therapeutic strategies, constitutes roughly 20% of all breast cancer cases. TNBC cells lack receptors for estrogen, progesterone, and human epidermal growth factor. The effort continues to find a suitable correlate that could serve as a TNBC biomarker, or as therapeutic target, or both.

Materials and Methods:
A retrospective study was performed with 88 TNBC and 74 non-TNBC patients who had undergone mastectomy/lumpectomy with axillary clearance for carcinoma breast. Immunohistochemical staining was carried out for levels of proteinase-activated receptor 2 (PAR2), encoded by F2RL1 gene, and staining scores were calculated, based on intensity and percentage positivity.

Results:
PAR2 levels were markedly upregulated in TNBC patients, compared with patients with other breast cancer subtypes. Amongst different non-TNBC subtypes, higher expression was noted in luminal B (88.8%) and HER2+ (100%), compared with luminal A (52.5%). PAR2 levels were significantly high in TNBC patients with age more than 40 years than corresponding patients of non-TNBC group (P=0.0017). Furthermore, there was a statistically significant increase in levels of PAR2 expression in lymph node negative (P=0.0096) and early stage (P=0.005) of TNBC versus non-TNBC patients. PAR2 staining of ductal carcinoma in situ and invasive ductal carcinoma revealed lower expression in invasive component.

Conclusions:
Our data suggest that PAR2 levels constitute a correlate of concern for TNBC, tying in with a recent report that higher levels of F2RL1 gene expression correlate with poorer disease-free, as well as overall survival in TNBCs.
Vasculitis in Patients With Sarcoidosis
Authors: Kimbrough Bradly A. , Warrington Kenneth J. , Langenfeld Hannah E. , Crowson Cynthia S. , Carmona Eva M. , Virata Andrew R. , Koster Matthew J. 
Published: March 2022

Objectives
Vasculitis in patients with sarcoidosis is rare and can affect any sized blood vessel. Limited information describing this association is available.

Methods
A single-institution medical records review study was performed reviewing all patients with a diagnosis code for sarcoidosis and vasculitis between January 1, 1998, and December 31, 2019. Data were abstracted regarding diagnosis, treatment, and outcomes from medical records. Patients were diagnosed with vasculitis based on biopsy and/or arterial imaging. Comparison between patients presenting with large and/or medium vessel vasculitis (L/MVV) versus patients with only small vessel vasculitis (SVV) was performed.

Results
Seventeen patients were identified during the study period. Nine patients (56% female) had L/MVV, and 8 (50% female) had SVV. Sarcoidosis preceded vasculitis in 4 (44%) L/MVV and 3 (38%) SVV. The mean ± SD age at sarcoidosis diagnosis was 53.2 ± 17.8 and 51.9 ± 11.4 years, and the mean ± SD age at vasculitis diagnosis was 57.4 ± 19.6 and 59.0 ± 13.4 years in L/MVV and SVV, respectively. Number of organ systems involved by sarcoidosis was similar (median [interquartile range], 3 [1–4] L/MVV vs 2.5 [1.75–3.25] SVV). The mean length of follow-up was 11.5 ± 12.8 in L/MVV and 13.1 ± 14.3 years in SVV. Complete response to therapy for vasculitis was observed in 8 of 9 with L/MVV and 7 of 8 with SVV. Four patients with SVV were able to stop all immunosuppression as compared with only 1 patient with L/MVV at the last follow-up.

Conclusions
This series observed a comparable number of patients with L/MVV and SVV. Although a variety of treatments were used, most patients achieved remission regardless of vessel size affected. Clinicians should be aware of the overlap between sarcoidosis and vasculitis.
Interrater Reliability, Acceptability, and Practicality of Real-Time Video Pediatric Gait, Arms, Legs, and Spine for Musculoskeletal Assessment of Children During Telemedicine Visits
Authors: Giray Esra , Kenis-Coskun Ozge , Karadag-Saygi Evrim , Ozyemisci-Taskiran Ozden 
Published: March 2022

Background/Objective
With the COVID-19 (coronavirus disease 2019) pandemic, telemedicine applications gained momentum, and clinicians tried to develop various musculoskeletal examination methods to be used in telemedicine visits. The aim of this study is to investigate the interrater reliability, acceptability, and practicality of the real-time video Pediatric Gait, Arms, Legs, and Spine (v-pGALS) assessment used in the evaluation during the telemedicine visit.

Methods
The study was designed as cross-sectional. Twenty school-aged children who presented to outpatient clinics with musculoskeletal complaints were included. For interrater reliability, the children were evaluated by face-to-face examination with v-pGALS, and then the child was reevaluated by another physiatrist with real-time evaluation (online video call) with the help of a parent. For acceptability, the time taken and the discomfort caused were evaluated by patients/parents with the smiley face visual analog scale, whereas to assess practicality, the ratio of completeness to duration of examination completion was recorded.

Results

κ coefficient of the agreement was found to be 0.88 between the results of the face-to-face examination and online video examination, suggesting very good agreement between the 2 raters. Acceptability of v-pGALS by parents and patients was high; 60% of children and 80% of parents found the duration of examination acceptable, and 70% of the patients and 95% of parents reported no discomfort caused by examination. The duration of face-to-face examination was 5.75 ± 1.29 minutes, whereas the duration of online examination was 15.81 ± 4.9 minutes.

Conclusions
Video pGALS is a reliable, acceptable, and practical examination system that can be used for musculoskeletal assessment of children in telemedicine visits.
Coronary Computed Tomography Angiography-Based Calcium Scoring
Authors: Emrich Tilman , Aquino Gilberto , Schoepf U. Joseph , Braun Franziska M. , Risch Franka , Bette Stefanie J. , Woznicki Piotr , Decker Josua A. , O’Doherty Jim , Brandt Verena , Allmendinger Thomas , Nowak Tristan , Schmidt Bernhard , Flohr Thomas , Kroencke Thomas J. , Scheurig-Muenkler Christian , Varga-Szemes Akos , Schwarz Florian 
Published: March 2022

Purpose
The aim of this study was to evaluate coronary computed tomography angiography (CCTA)-based in vitro and in vivo coronary artery calcium scoring (CACS) using a novel virtual noniodine reconstruction (PureCalcium) on a clinical first-generation photon-counting detector–computed tomography system compared with virtual noncontrast (VNC) reconstructions and true noncontrast (TNC) acquisitions.

Materials and Methods
Although CACS and CCTA are well-established techniques for the assessment of coronary artery disease, they are complementary acquisitions, translating into increased scan time and patient radiation dose. Hence, accurate CACS derived from a single CCTA acquisition would be highly desirable. In this study, CACS based on PureCalcium, VNC, and TNC, reconstructions was evaluated in a CACS phantom and in 67 patients (70 [59/80] years, 58.2% male) undergoing CCTA on a first-generation photon counting detector–computed tomography system. Coronary artery calcium scores were quantified for the 3 reconstructions and compared using Wilcoxon test. Agreement was evaluated by Pearson and Spearman correlation and Bland-Altman analysis. Classification of coronary artery calcium score categories (0, 1–10, 11–100, 101–400, and >400) was compared using Cohen κ.

Results
Phantom studies demonstrated strong agreement between CACSPureCalcium and CACSTNC (60.7 ± 90.6 vs 67.3 ± 88.3, P = 0.01, r = 0.98, intraclass correlation [ICC] = 0.98; mean bias, 6.6; limits of agreement [LoA], −39.8/26.6), whereas CACSVNC showed a significant underestimation (42.4 ± 75.3 vs 67.3 ± 88.3, P < 0.001, r = 0.94, ICC = 0.89; mean bias, 24.9; LoA, −87.1/37.2). In vivo comparison confirmed a high correlation but revealed an underestimation of CACSPureCalcium (169.3 [0.7/969.4] vs 232.2 [26.5/1112.2], P < 0.001, r = 0.97, ICC = 0.98; mean bias, −113.5; LoA, −470.2/243.2). In comparison, CACSVNC showed a similarly high correlation, but a substantially larger underestimation (24.3 [0/272.3] vs 232.2 [26.5/1112.2], P < 0.001, r = 0.97, ICC = 0.54; mean bias, −551.6; LoA, −2037.5/934.4). CACSPureCalcium showed superior agreement of CACS classification (κ = 0.88) than CACSVNC (κ = 0.60).

Conclusions
The accuracy of CACS quantification and classification based on PureCalcium reconstructions of CCTA outperforms CACS derived from VNC reconstructions.
In-hospital outcomes of intercostal nerve cryoablation and surgical stabilization of rib fractures
Authors: Fernandez Carlos A. , Narveson Joel R. , Niu Fang , Norton Elizabeth , Brown Emily C. , Punja Viren , Veatch Jessica M. , Capasso Thomas , Patel Neil D. , Ewing Kaily , Kuncir Eric 
Published: March 2022

BACKGROUND
Severe pain and pulmonary complications commonly follow rib fractures, both of which may be improved by surgical stabilization of rib fractures (SSRFs). However, significant postoperative pain still persists which may negatively impact in-hospital outcomes. Combining intercostal nerve cryoablation (INCA) with SSRF may improve those outcomes by further decreasing postoperative pain, opioid consumption, and pulmonary complications. The hypothesis is that INCA plus SSRF reduces opioids consumption compared with SSRF alone.

METHODS
The retrospective analysis included trauma patients 18 years or older who underwent SSRF, with or without INCA, in a Level I trauma center between 2015 and 2021. Patients received INCA at the surgeons' discretion based on familiarity with the procedure and absence of contraindications. Patients without INCA were the historical control group. Reported data include demographics, mechanism and severity of injury, number of ribs stabilized, cryoablated nerves, intubation rates and duration of mechanical ventilation. The primary outcome was total morphine milligrams equivalent consumption. Secondary outcomes were intensive care unit length of stay, hospital length of stay, incidence of pneumonia, and tracheostomy rates, and discharge disposition. Long-term outcomes were examined up to 6 months for adverse events.

RESULTS
Sixty-eight patients were included, with 44 receiving INCA. There were no differences in rates of pneumonia (p = 0.106) or duration of mechanical ventilation (p = 0.687), and hospital length of stay was similar between groups (p = 0.059). However, the INCA group demonstrated lower total morphine milligrams equivalent (p = 0.002), shorter intensive care unit length of stay (p = 0.021), higher likelihood of home discharge (p = 0.044), and lower rate of intubation (p = 0.002) and tracheostomy (p = 0.032).

CONCLUSION
Combining INCA with SSRF may further improve in-hospital outcomes for patients with traumatic rib fractures.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
Impact of Transition from Conventional Open Radical Cystectomy to Laparoscopic Radical Cystectomy for Neobladder: A Retrospective Study
Authors: Shah Rupesh B , Trivedi Amit D , Rajyaguru Ketan B , Bhatt Parloop A 
Published: March 2022

AbstractBackgroundEarly operative recovery and good Quality of life are important goals of radical cystectomy. We compare the pre, peri and post operative data between Open radical cystectomy (ORC) and Laparoscopic radical cystectomy (LRC) surgery of neobladder.Patients and MethodsRetrospective analysis of 13 male consecutive patients who underwent radical cystectomy by a single surgeon was done. Diagnosis of all patients was of invasive bladder cancer. Abdominal and preoperative staging was done using computed tomography. None of them received neoadjuvant chemotherapy. All the patients received same standard template bilateral pelvic lympadenenectomy. The urinary diversion included orthotopic neobladder. All patients were consented prior to study participation.ResultsOf the 13 male patients, six had ORC with neobladder while 7 underwent LRC surgery. Baseline characteristics (age, BMI, comorbidities, tumour grade, lymph node status) were similar in both groups. Incision length was significantly smaller in LRC as compared to ORC group (p <0.0001). Although the operative time was longer in LRC group as compared to ORC it was sufficed by reduced time for analgesics, shorter hospital stay (p<0.05), besides earlier time to liquid intake with immediate removal of nasogastric tube (p<0.001). No major complications were observed in the LRC unlike ORC group where one patient died at 30 days.ConclusionsBased on the observations of our small study sample peri and postoperative outcomes are promising for LRC compared to ORC for patients undergoing neobladder in terms of the smaller incision length associated with less pain and complications, with speedy recovery without jeopardizing oncological outcomes. Transition of surgeon from ORC to LRC was advantageous to patients.