bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Repetitive and Prolonged Eye Rubbing on Corneal Biomechanics
Authors: Torres-Netto Emilio A. , Abdshahzadeh Hormoz , Abrishamchi Reyhaneh , Hafezi Nikki L. , Hillen Mark , Ambrósio Renato , Randleman J. Bradley , Spoerl Eberhard , Gatinel Damien , Hafezi Farhad 
Published: September 2022

PURPOSE:
To evaluate the effect of simulated repetitive eye rubbing on the corneal biomechanics of porcine eyes using an ex vivo model system.

METHODS:
The average rubbing force that patients with keratoconus apply to their eyelids was previously determined. Fresh porcine eyes with eyelids were either exposed to 10,500 rub cycles from a custom-built eye rubbing machine that rubbed with a similar force to knuckle human eye rubbing (n = 33) or no rubbing at all (control; n = 37). A total of 10,500 rubs are equivalent to 1 year of rubbing six times daily, five movements per rub. The corneal biomechanical properties of these eyes were then tested by measuring the elastic modulus of 5-mm strips.

RESULTS:

The elastic modulus at the range of 1% and 5% of strain was 1.219 ± 0.284 and 1.218 ± 0.304 N/mm
2
in the eye rubbing group and the no-rub control group, respectively. Corneal stiffness was similar in both groups (
P
= .984).

CONCLUSIONS:
The threshold to induce biomechanical changes (purely by eye rubbing) must be higher than 10,500 rubbing movements, suggesting that occasional eye rubbing may not affect corneal biomechanics in normal eyes, and likely only triggers keratoconus progression in predisposed corneas. Further in vivo studies assessing the impact eye rubbing has on inflammatory activity and the biomechanical properties of weakened corneas is warranted.

[
J Refract Surg
. 2022;38(9):610–616.]
Toric Intraocular Lens Calculations With the Barrett Calculator: A Comparison of the Calculator With and Without the Integrated K Method
Authors: Reitblat Olga , Harel Gal , Zlatkin Rita , Bahar Irit , Sella Ruti 
Published: September 2022

PURPOSE:
To compare the accuracy of the Barrett Integrated K (IK) toric calculator with the standard Barrett toric calculator.

METHODS:
Consecutive patients who underwent cataract extraction with implantation of a toric intraocular lens at the Rabin Medical Center, Israel, were reviewed. Errors in predicted postoperative refractive astigmatism were calculated for the Barrett toric calculator using biometry measurements only and with the IK tool using biometry and tomography. Both methods were assessed with predicted and measured posterior corneal astigmatism (PPCA and MPCA, respectively).

RESULTS:

The study included 73 eyes of 59 patients. The mean centroid prediction error using PPCA (0.08 ± 0.80 D @ 78°) was significantly different compared with MPCA (0.07 ± 0.80 D @ 48°,
P
= .016). In addition, a significant difference between IK-PPCA (0.06 ± 0.80 D @ 80°) and IK-MPCA (0.05 ± 0.80 D @ 38°) was found (
P
= .023). The median absolute prediction error ranged from 0.55 D using IK-PPCA to 0.60 D using PPCA, with no significant differences between the four calculation versions. No significant differences were found between the calculators in the predictability rates within ±0.50, ±0.75, and ±1.00 D. Analysis of one eye of each patient showed similar results.

CONCLUSIONS:
The IK calculator yielded comparable outcomes to the standard Barrett calculator. Although differences in the mean centroid errors were found, they were clinically insignificant and predominantly seen in the axis of the predicted astigmatism error. These minor differences were mainly attributed to the incorporation of the MPCA in the calculation.

[
J Refract Surg
. 2022;38(9):565–571.]
The Effects of High Energy Capsulotomy on Aqueous Cytokine Profiles and Pupil Size During Femtosecond Laser–Assisted Cataract Surgery
Authors: Stewart Stephen , Liu Yu-Chi , Setiawan Melina , Lin Molly Tzu-Yu , Lee Isabelle Xin Yu , Sim Nigel , Htoon Hla Myint , Ong Hon Shing , Mehta Jodhbir S. 
Published: September 2022

PURPOSE:
To assess whether aqueous cytokine profiles and pupil size are altered when high capsulotomy energy is used in eyes undergoing femtosecond laser–assisted cataract surgery (FLACS), and if preoperative use of a topical non-steroidal anti-inflammatory drug (NSAID) has an effect on this.

METHODS:
This prospective study recruited 83 eyes (63 patients) that were allocated to four treatment groups: conventional phacoemulsification (n = 20 eyes); FLACS with 90% capsulotomy energy without NSAID pretreatment (n = 20 eyes); FLACS with 90% capsulotomy energy with NSAID pre-treatment (n = 21 eyes); and FLACS with 150% capsulotomy energy with NSAID pretreatment (n = 22 eyes). Aqueous humor was collected before and after phacoemulsification to assess cytokine profiles. Pupil size was measured before and after laser capsulotomy.

RESULTS:

FLACS increased aqueous concentrations of pros-taglandin E
2
(PGE
2
), interferon γ (IFN-γ), and interleukin 6 (IL-6) compared to conventional phacoemulsification. However, when increasing capsulotomy energy from 90% to 150% (with topical NSAID pretreatment), there was no significant increase in aqueous concentrations of PGE
2
(37.7 ± 21.7 vs 33.6 ± 27.6 pg/mL,
P
= .99), IFN-γ (3.6 ± 1.1 vs 3.6 ± 0.8 pg/mL,
P
= .99), or IL-6 (7.1 ± 2.9 vs 6.3 ± 2.4 pg/mL,
P
= .99). For 90% and 150% capsulotomy energy, there was significant miosis following laser capsulotomy. Increased PGE
2
concentration was significantly correlated with a reduction in pupil area (
r
= −0.58,
P
< .001) and pupil diameter (
r
= −0.57,
P
< .001). However, when a topical NSAID was given preoperatively, there was no difference in the degree of miosis between the 90% and 150% capsulotomy energy groups.

CONCLUSIONS:

Pretreatment with a topical NSAID prevented a rise in PGE
2
, IFN-γ, and IL-6 levels and excessive miosis when a higher capsulotomy energy was used. When a topical NSAID is used preoperatively, it is safe to use higher capsulotomy energy settings (with a low pulse energy femtosecond laser system) to achieve a satisfactory capsulotomy.

[
J Refract Surg
. 2022;38(9):587–594.]
Validation of the Brazilian Oral Health Literacy-Adults Questionnaire
Authors: Almeida Eliete Rodrigues , Sistani Mohammad Mehdi Naghibi , Bendo Cristiane Baccin , Pordeus Isabela de Almeida , Firmino Ramon Targino , Paiva Saul Martins , Ferreira Fernanda Morais 
Published: September 2022

Background:
Recognizing that a deficit of reading and numeracy skills is associated with poorer oral health, contemporary researchers have identified additional components as important attributes of oral health literacy (OHL). So, the use of comprehensive functional OHL tools is crucial. The Oral Health Literacy-Adults Questionnaire (OHL-AQ) evaluates reading comprehension, numeracy, listening and decision-making skills.

Objective:
Describe the validation process of the OHL-AQ Brazilian version (BOHL-AQ).

Methods:

The cross-culturally adapted version, BOHL-AQ, was applied to 180 employees age 18 to 71 years (mean = 37.2; standard deviation [
SD
] = 11.7) from a private university located in the Southeast of Brazil. Psychometric properties were evaluated through the analysis of internal consistency (Cronbach's alpha), reproducibility (test-retest), convergent validity (BREALD-30; education level), discriminant validity (family income; dental services), predictive validity (self-perception; literacy questions) and construct validity (Exploratory Factor Analysis). Confirmatory Factor Analysis (CFA) evaluated the dimensionality of the BOHL-AQ, with Promax method for rotation. Data were analyzed using SPSS Statistics software and the Mplus program.

Key Results:

BOHL-AQ mean score = 11.84 (
SD
= 3.1); administration mean time = 8 minutes (
SD
= 1.6); good internal reliability (Cronbach's alpha = 0.73) and excellent reproducibility (kappa = 0.89; intraclass correlation coefficient = 0.97). Preliminary tests showed that data were suitable for PCA (Kayser-Meyer-Olkin measure = 0.75; Barlett's Test of Sphericity significant [
p
< .001]). CFA showed that the instrument had a four-factor solution with excellent model fit estimates (χ
2
= 636.587154.16,
p
value = .00117, Comparative Fit Index = 0.9787, Tucker Lewis index = 0.97, and Root Mean Square Error of the Approximation = 0.03). BOHL-AQ high scores significantly correlated to high education level, dental visit within the last year and for preventive reason, more independence and self-confidence on reading and filling out health forms, and better oral health self-perception (
p
< .05).

Conclusions:

The BOHL-AQ showed to be a fast and reliable instrument to assess a comprehensive functional OHL at Brazilian community and clinical settings. [

HLRP: Health Literacy Research and Practice
. 2022;6(3):e224–e231.

]

Plain Language Summary:
Recognizing the need of advancing knowledge related to OHL, this study aimed to describe the validation process of the BOHL-AQ. Cross-cultural adaptation and psychometric properties evaluation presented satisfactory results. The BOHL-AQ proved to be a fast and valid instrument to measure comprehensive functional OHL in the Brazilian context.
Strong Basal/Tonic TCR Signals Are Associated with Negative Regulation of Naive CD4+ T Cells
Authors: Zinzow-Kramer Wendy M , Kolawole Elizabeth M , Eggert Joel , Evavold Brian D , Scharer Christopher D , Au-Yeung Byron B 
Published: September 2022

Abstract
T cells experience varying intensities of tonic or basal TCR signaling in response to self-peptides presented by MHC (self-pMHC) in vivo. We analyzed four subpopulations of mouse naive CD4+ cells that express different levels of Nur77-GFP and Ly6C, surrogate markers that positively and inversely correlate with the strength of tonic TCR signaling, respectively. Adoptive transfer studies suggest that relatively weak or strong Nur77-GFP intensity in thymocytes tends to be maintained in mature T cells. Two-dimensional affinity measurements were lowest for Nur77-GFPloLy6C+ cells and highest for Nur77-GFPhiLy6C− cells, highlighting a positive correlation between apparent TCR affinity and tonic TCR signal strength. Despite experiencing the strongest tonic TCR signaling, Nur77-GFPhiLy6C− cells were least responsive to multiple concentrations of a cognate or suboptimal pMHC. Gene expression analyses suggest that Nur77-GFPhiLy6C− cells induce a gene expression program that has similarities with that of acutely stimulated T cells. However, strong tonic TCR signaling also correlates with increased expression of genes with inhibitory functions, including coinhibitory receptors. Similarly, assay for transposase-accessible chromatin with sequencing analyses suggested that increased tonic TCR signal strength correlated with increased chromatin accessibility associated with genes that have positive and inhibitory roles in T cell activation. Strikingly, Nur77-GFPhiLy6C− cells exhibited differential accessibility within regions of Cd200r1 and Tox that were similar in location to differentially accessible regions previously identified in exhausted CD8+ T cells. We propose that constitutive strong tonic TCR signaling triggers adaptations detectable at both the transcriptional and epigenetic levels, ultimately contributing to the tuning of T cell responsiveness.
MARCH1 Controls an Exhaustion-like Program of Effector CD4+ T Cells Promoting Allergic Airway Inflammation
Authors: Castellanos Carlos A , Hiam-Galvez Kamir J , Ishido Satoshi , Satpathy Ansuman T , Shin Jeoung-Sook 
Published: September 2022

Abstract
Persistent antigenic signaling leads to T cell exhaustion, a dysfunctional state arising in many chronic infections and cancers. Little is known concerning mechanisms limiting exhaustion in immune-stimulatory diseases such as asthma. We report that membrane-associated RING-CH1 (MARCH1), the ubiquitin ligase that mediates surface turnover of MHC class II (MHCII) and CD86 in professional APCs, plays an essential role in restraining an exhaustion-like program of effector CD4+ T cells in a mouse model of asthma. Mice lacking MARCH1 or the ubiquitin acceptor sites of MHCII and CD86 exhibited increased MHCII and CD86 surface expression on lung APCs, and this increase promoted enhanced expression of immune-inhibitory receptors by effector CD4+ T cells and inhibited their proliferation. Remarkably, ablation of MARCH1 in mice with established asthma reduced airway infiltration of eosinophils and Th2 cells. Thus, MARCH1 controls an exhaustion-like program of effector CD4+ T cells during allergic airway inflammation and may serve as a therapeutic target for asthma.
Sporadic hemangioblastoma of cauda equina
Authors: D' Oria Salvatore , Giraldi David , Flores Daniel Andres Alvarado , Murrone Domenico , D' Angelo Vincenzo , Chaurasia Bipin 
Published: September 2022

Background
Hemangioblastomas (HBs) are rare lesions accounting for 1%–5% of all spinal cord tumors, and are mostly associated with Von Hippel-Lindau (VHL) syndrome. Localization in the cauda equina is uncommon.

Aim:
In this manuscript, we aimed to describe a rare case of sporadic intradural extramedullary HB of the cauda equina and present a literature review.

Mathods:
A systematic research was performed on PubMed, MEDLINE, and Google Scholar, using the keywords “spinal HB” and “cauda equina tumors.” The previous literature is integrated by the description of the present case. A 49-year-old female presented in August 2020 to our institution with a magnetic resonance imaging (MRI) which showed an intradural mass at L1/2 level and angiography that showing a nidus of serpiginous vessels inside the lesion. Symptoms were right sciatica and paresthesia in right L5 radicular dermatome for more than 3 months. Neurological examination revealed claudicatio spinalis and hypoesthesia on right L5 dermatome and weakness of right anterior tibialis muscle. Microsurgical en bloc resection of lesion was performed with adjuvant neurophysiological intraoperative monitoring. The histological examination provided the diagnosis of HB.

Results:
After surgery, symptoms and neurological impairment gradually improved. Postoperative MRI showed no residual tumor.

Conclusions:
Although intradural extramedullary HB of the cauda equina without VHL syndrome is a rare pathological entity, this diagnosis must be taken in consideration when a mass affects cauda equina. Preoperative embolization is an option to minimize intraoperative bleeding. Radiosurgery seems to prevent recurrences when the tumor is not completely excised. A complete surgical removal of the lesion is usually possible and it leads to a low likelihood of recurrence.
Intraoral pencil core granuloma with retained pencil lead
Authors: Jain Mansi , Kumar Sanjay , Saroch Nitin , Singh Tejinder P. 
Published: September 2022

Abstract
Foreign body impactions can be frequently seen in childhood as children have a habit of putting different objects in the mouth. These impacted foreign bodies if not removed timely, at times can lead to severe reactions leading to granuloma formation. A simple injury, if ignored, can result in severe damage to oral tissue and even loss of the permanent tooth. Therefore, all penetrating injuries should be carefully assessed and treated timely. This study describes a rarest intraoral case of pencil core granuloma with retained graphite lead inside it that led to severe tissue reactions. Pencil core granuloma has been reported extra orally and on limbs. This case report describes the rarest case reported intraorally.
Sciatica. Management for family physicians
Authors: Aguilar-Shea Antonio L. , Gallardo-Mayo Cristina , Sanz-González Rosa , Paredes Igor 
Published: September 2022

Abstract
Sciatica or lower back pain with sciatic radiation is a frequent medical problem in primary care. The aim of this article is to better inform medical practitioners on diagnosis and management of lower back pain with sciatic radiation. Updated information on sciatica management is important for family physicians. Here, we review the available literature on sciatica. Relevant articles were identified via a literature search in PubMed by focusing on the following key points: diagnostic and definition criteria, red flags, and therapy. In addition, the authors’ clinical experience has been utilised to propose a schema to assist in the assessment and treatment of sciatica in a primary care setting. Sciatica diagnosis is based on a careful history and clinical examination. Imaging is usually not necessary at first; testing with X-ray and MRI are key to diagnosing lumbar instability and herniated discs. Management includes physical conditioning, proper pain management, and surgery as a last resort. Pain treatment includes analgesics, anticonvulsants and muscle relaxants. A more aggressive approach would include epidural infiltrations and radiofrequency.
Needling, lasers, and Meso-Botox for hypertrophic and keloidal scars: A comprehensive review study on promising procedural treatments
Authors: Dilmaghani Sara , Behrangi Elham , Mazandarani Monireh , Pourali Ali , Sadeghi Sara , Khosravi Mina , Goodarzi Azadeh 
Published: September 2022

AbstractScars are among the most prevalent referral cases of dermatology clinics, including atrophic, hypertrophic, or keloidal scars. Approach to scar usually needs a holistic trend, attention to individualized characteristics, and combination therapy. Scars usually need multiple sessions of therapy and the use of combination therapeutic approaches to reach the most acceptable outcomes by safe modalities. Studies on scars are always one of the most important fields of research in medicine, especially in dermatology. For writing this review study, we searched all the databases to find the most relevant and the newest studies related to our topic, because based on expert opinion, this topic may be really practical and interesting for dermatologists and all physicians of various specialties or subspecialties who manage and treat various kinds of scars, including hypertrophic scars and keloids. Based on our results, we concluded that different procedures, which basically use needling, lasers, especially pulsed dye laser (PDL) and carbon dioxide (CO2) laser, and MesoBotox (micro-injection of botulinum toxin), are really promising therapeutic options for hypertrophic and keloidal scars and a combination of these therapies results in more efficacy and lesser side effects in the field of scar management.
Histopathology spectrum of skin lesions in teaching institution
Authors: Goswami Parth , Parekh Manushi , Goswami Alpeshpuri 
Published: September 2022

Introduction:
The skin has many functions and is a complex organ. Epidermis with skin adnexa, melanocytic system, dermis and subcutis are three main anatomic components of skin. Skin diseases are common in developing countries, prevalent among all age groups and up to 2000 skin diseases are known until now. Skin diseases show many different geographical patterns which range from simple vesicular non-neoplastic lesion to fatal neoplastic lesion. Histopathological examination of skin biopsy is necessary for accurate diagnosis, to identify etiological agents and to guide dermatologist or clinician for deciding appropriate management.

Aim and Objectives:
Present study was carried out to understand prevalence and spectrum of various skin lesion in correlation with age, sex and site of involvement at tertiary care hospital and so to educate community and physicians accordingly after study results.

Material and Methods:
Study Design: Non-interventional, cross-sectional, retrospective study was carried out on all skin biopsies at department of pathology, government medical college Bhavnagar, Gujarat, irrespective of age, sex and clinical diagnosis for Study Duration: from January 2017 to January 2020 for three years.

Results:
Out of 610 biopsies, Seborrheic keratosis, Leprosy and Basal cell carcinoma were commonly observed non-neoplastic, infective and neoplastic skin lesions, respectively. In our study, most common involved age group is >60 years and male preponderance.

Conclusion:
Leprosy and Basal cell carcinoma were most commonly observed infective and neoplastic skin lesion in our study respectively. Therefore, community should be educated to prevent airborne droplet transmission and repeated unprotected ultraviolet light sun exposure to reduce the prevalence of both these diseases. We suggest such type of study in different geographical area to plan preventive strategy to reduce morbidity due to various skin lesion.
Effectiveness of using technology as health education tool among diabetes patients in South India: A comparative analysis and community based intervention
Authors: HN Harshitha , Kundapur Rashmi , BY Yuvaraj , Panda Meely 
Published: September 2022

Introduction:
Type 2 diabetes mellitus is a serious, progressive condition presenting with chronic hyperglycemia. Its prevalence is gradually increasing at a global level. A diabetic has to make multiple choices daily about the management of their condition, such as appropriate dietary intake, physical activity and adherence to drugs. There is hardly any input from a healthcare professional for guidance on a daily basis.

Objectives:
The aims of this study were to assess the change in knowledge by using various methods of health education as intervention and to compare the effect of technology as a tool of health education as compared to conventional methods of health education.

Materials and Methods:
A community-based interventional study was done in the field practice area of our Institute in South India. Two groups of people were selected from 40 adopted houses. One from urban; for intervention with technology, that is, health education using videos and the second group from rural population; for intervention with conventional method of health education, that is, using charts.

Results:
The mean baseline knowledge score in urban and rural area was 3.76 and 9.97, respectively. There was statistically significant increase in knowledge among both the groups. By the use of technology in the urban population knowledge level increased from 3.76 to 10.15 and was found to be statistically significant. The difference in increase in knowledge was higher in the technology group as compared to conventional group.

Conclusion:
In the era of smartphone, technology-based health education can reduce the total health care manpower which is deficient. Technology is a boon to introduce lifestyle modification in chronic diseases like Diabetes Mellitus.
Markov model- Quantifying outlook towards success of tobacco cessation counseling
Authors: Nikose Yashasvi , Madhu Priyanka P. , Reche Amit , Agarwal Priya , Jidewar Namrata , Sayyed Maviya , Chhabra Kumar G. 
Published: September 2022

Abstract
Smoking is still a major public health issue that causes morbidity and mortality all over the world. The percentage of deaths caused by tobacco smoking has escalated from 1.4% in 1990 to 13.3% by 2020. There are numerous evidence-based tobacco control strategies available, and newer ones are always being developed. However, on ceasing the habit, cigarettes users go through a period of withdrawal with an increased percentage of relapse before entering to a more stable condition of sobriety in the long run. In this review, Endnote software was used as resource material to collect literature, which was then carefully arranged in a synchronised way. The Markov model captures the dynamic character of the quitting/relapse process, allowing for more accurate figures of abstinence rate, treatment outcomes and evaluating the performance of newer cessation initiatives during tobacco cessation counselling, as well as suggesting pathways for survivability.