bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Analysis of the Clinical Outcomes of Mix-and-Match Implantation of an Extended Depth-of-Focus and a Diffractive Bifocal Intraocular Lens
Authors: Kim Seonjoo , Yi Rowoon , Chung So-Hyang 
Published: March 2022

Objectives:
To evaluate and compare the clinical outcomes of the extended depth-of-focus intraocular lens (EDOF-IOL) and the diffractive bifocal IOL.

Methods:
Fifty-six eyes of 28 patients underwent cataract surgery with implantation of an EDOF-IOL (TECNIS Symfony, ZXR00) in their dominant eye and a diffractive bifocal IOL (+3.25 D add TECNIS ZLB00) in their nondominant eye. Monocular and binocular uncorrected distance, intermediate and near visual acuity, defocus curves, contrast sensitivity, patient satisfaction score (0–5), and spectacle dependence at near vision were evaluated at 3 months after the surgery.

Results:
Postoperative binocular uncorrected distant visual acuity was 0.009±0.031 logMAR, uncorrected intermediate visual acuity was 0.090±0.158 logMAR, and uncorrected near visual acuity was 0.099±0.068 logMAR. The monocular defocus curve demonstrated better performance at intermediate distance in eyes with an EDOF-IOL and better performance at near distance in eyes with a diffractive bifocal IOL. An EDOF-IOL exhibited better outcomes in contrast sensitivity compared with a diffractive bifocal IOL. Three patients (10.7%) required glasses for near vision.

Conclusion:
Mix-and-match implantation of a diffractive bifocal IOL with an EDOF-IOL provides an excellent range of vision, and high levels of contrast sensitivity and patient satisfaction.
Scleral Lens Thickness and Corneal Edema Under Open Eye Conditions
Authors: Fisher Damien , Collins Michael J. , Vincent Stephen J. 
Published: March 2022

Purpose:
To examine the relationship between lens thickness and central corneal edema during short-term open-eye scleral lens wear, and to compare these empirical edema measurements with theoretical modelling.

Methods:
Nine participants (mean age 30 years) with normal corneas wore scleral lenses {Dk 141×10−11 cm3 O2 [cm]/([sec] [cm2] [mm Hg])} under open-eye conditions on separate days with nominal center thicknesses of 150, 300, 600, and 1,200 μm. Epithelial, stromal, and total corneal edema were measured using high-resolution optical coherence tomography immediately after lens application and after 90 min of wear, before lens removal.

Results:
Central corneal edema was primarily stromal in nature and increased with increasing central lens thickness. The mean±standard error total corneal edema was 1.14±0.22%, 1.36±0.26%, 1.74±0.30%, and 2.13±0.24% for the 150, 300, 600, and 1,200 μm lenses, respectively. A significant difference in stromal and total corneal edema was observed between the 1,200 and 150 μm thickness lenses only (both P<0.05). Theoretical modelling overestimated the magnitude of central corneal edema and the influence of central lens thickness when the scleral lens Dk/t was less than 20.

Conclusion:
Scleral lens-induced central corneal edema during short-term open-eye lens wear increases with increasing central lens thickness. Theoretical models overestimated the effect of increasing scleral lens thickness upon central corneal edema for higher lens thickness values (lens Dk/t<20) when controlling for initial central fluid reservoir thickness.
Microbial Keratitis Associated With Penetrating Keratoplasty and Scleral Lens Wear: A Case Series
Authors: Kawulok Eric R. , Nau Cherie B. , Schornack Muriel M. 
Published: March 2022

Objectives:
To report on microbial keratitis (MK) in three scleral lens (SL) wearers who had undergone penetrating keratoplasty (PKP).

Methods:
This retrospective case series describes 3 cases of MK in patients who wore SLs after PKP.

Results:
All three patients wore SLs for visual rehabilitation for corneal irregularity induced by PKP; all three also had concurrent ocular surface disease (keratoconjunctivitis sicca and corneal exposure). Cultures identified the causative organism in two patients, and septated hyphae suggestive of fungal infection were identified in tissue removed during therapeutic PKP in the third patient. All three patients were receiving either topical or systemic immunosuppressive therapy before the infection developed.

Conclusions:
Scleral lenses are often used to manage complex ocular disease, which can make it difficult to determine the precise cause of complications that arise after wearing the lenses. Multiple factors, including SL wear, may have contributed to the initial development of MK in the three patients in this case series. Patients who wear SLs after PKP should be monitored closely.
The Impact of Australian Childhood Vaccination Mandates on Immunization Specialists and Their Interactions With Families
Authors: Yap Natalie , Buttery Jim , Crawford Nigel W. , Omer Saad , Heininger Ulrich ,   on behalf of the AEFI CAN Group
Published: March 2022

Background:
Recent global outbreaks of vaccine-preventable diseases, both before and since the coronavirus disease 2019 pandemic, have led to the introduction or strengthening of vaccine mandate policies to target vaccine refusal. Globally, there is wide variation in how governments and jurisdictions implement and enforce mandatory vaccination as well as the financial and educational consequences to those who fail to comply. We explored the impact of mandate vaccination policies on Australian Immunization Specialists who work in Specialist Immunization Clinics (SIC) for approving vaccine exemptions outside of the mandated criteria. In particular, their interactions with patients and families.

Methods:
A national, prospective, mixed methods, survey-based study conducted with members of the Australian Adverse Event Following Immunisation Clinical Assessment Network between February 2020 and June 2020.

Results:
Sixteen Immunization physicians and nurse practitioner specialists working in a SIC completed the survey. All sixteen respondents had been requested by parents to provide a Medical Exemptions at least once. 88% of respondents felt pressure to provide an exemption that was not medically justified according to legislation. Seventy-five percent of SIC consultants felt that the “No Jab” policies created a moderate or extreme amount of stress to both themselves and parents. All respondents reported experiencing hostility from parents with three respondents having received threats of violence.

Conclusions:
Mandatory vaccination policies are associated with increased vaccination coverage but can result in widened financial and social inequity, and may harm families’ relationships with health care providers. Countries considering the implementation of vaccination mandates should use the least restrictive health policies to ensure a balance between the public health and individual benefit whilst minimizing burdens on health care professionals, children and their parents.
Are We Hitting the Target?
Authors: Elrod Julia , Yarmal Fatima , Mohr Christoph , Dennebaum Martin , Boettcher Michael , Vincent Deirdre , Reinshagen Konrad , Koenigs Ingo 
Published: March 2022

Background:
Currently, a range of different antibiotics are administered perioperatively during appendectomy surgery in the pediatric population. One reason for the lack of a uniform treatment regimen is the paucity of large studies on microbiologic data and susceptibility patterns.

Methods:
A retrospective, monocentric study on antibiotic susceptibility, including 1258 pediatric patients undergoing appendectomy from 2012 to 2020 was performed. Predictors for prolonged length of stay (LOS) and complications were determined using regression analysis, and objective criteria for broad-spectrum antibiotic regimens were identified. Simulations of the effectiveness of different antibiotic regimens against identified bacterial susceptibility results were conducted.

Results:
The most important predictors for prolonged LOS and an increased incidence of infectious complications are elevated preoperative C-reactive protein levels, high intraoperative severity gradings and insufficient primary antibiotic treatment. Based on our results, a simple antibiotic treatment, consisting of cefuroxime-metronidazole (C-M) or ampicillin-sulbactam (AS), is sufficient in around 85% of all patients; both options being equally efficient. In severe appendicitis, the likelihood of resistance is 31% and 32% for C-M and AS, respectively. For piperacillin-tazobactam and C-M-tobramycin, the incidence of bacterial resistance decreases to 12%. Resistance is reduced to 8% for AS-tobramycin treatment. The patient populations benefiting most from an extended antibiotic regimen are those with a high intraoperative severity grading.

Conclusions:
Evidence suggests that an insufficient antibiotic regimen is associated with a prolonged LOS and a higher rate of infectious complications, justifying the expansion of a simple antibiotic regimen in cases of severe intraabdominal findings. In all other cases, a simple antibiotic treatment with AS is recommended.
Evaluation of corneal biomechanical behavior in vivo for healthy and keratoconic eyes using the stress–strain index
Authors: Padmanabhan Prema , Lopes Bernardo T. , Eliasy Ashkan , Abass Ahmed , Vinciguerra Riccardo , Vinciguerra Paolo , Ambrósio Renato , Elsheikh Ahmed 
Published: March 2022

Purpose:
To evaluate the characteristics of corneal material properties in healthy individuals and keratoconic patients using the stress–strain index (SSI).

Setting:
Vincieye Clinic in Milan, Italy, and Instituto de Olhos Renato Ambrósio in Rio de Janeiro, Brazil.

Design:
Retrospective observational cross-sectional study.

Methods:
Records of 1221 patients were divided into 3 groups: healthy corneas (n = 728), bilateral keratoconus (KC, n = 388), and very asymmetric ectasia (VAE, n = 105) when patients presented with clinical ectasia in 1 eye and normal topography (VAE-NT) in the fellow eye. All patients were examined with Pentacam HR and Corvis ST. Severity of KC cases was stratified according to the Pentacam topographic KC classification. The SSI distribution across the different groups and its correlation with age, biomechanically corrected intraocular pressure (bIOP), and central corneal thickness (CCT) were assessed.

Results:
A statistically significant difference between healthy individuals and each of the keratoconic groups (P < .001) was observed, and a progressive reduction in the SSI was observed across the groups. A significant correlation was observed between the SSI and age in all groups (P < .010) but KC severe subgroup (P = .361). No correlation between the SSI and bIOP and CCT was observed in all KC subgroups and VAE-NT groups (P > .050). Among healthy eyes, there was only a mild correlation between the SSI and bIOP (R = 0.12, P = .002) and CCT (R = 0.13, P = .001).

Conclusions:
This study estimates the in vivo corneal material properties in healthy individuals and patients with KC using a new method. The SSI showed a progressive deterioration within the advance in disease stages while being relatively independent of bIOP and CCT but positively correlated with age.
Impact of Discharge Medication Reconciliation Across a Five-Hospital Health System
Authors: Lee Veronica , Kowalski Jaclyn , Liu Michael , Thayer Bailey 
Published: March 2022

ABSTRACT

Purpose:
Hospital readmission of a primary diagnosis can have a substantial financial impact via reductions in reimbursement rates up to 3%, and have a negative impact on the lives of patients. Discharge medication reconciliation (DMR) can reduce medication errors that play a role in readmission. The objective of this study is to evaluate the impact of expanding pharmacist-led DMR across a four hospital health system on 30-day readmission rate for high risk of readmission disease groups.

Methods:
During the 3-month period, DMR was performed for patients with at least one of the disease states associated with a high risk for 30-day readmission, including chronic obstructive pulmonary disease, pneumonia, congestive heart failure, or acute myocardial infarction.

Results:
The 30-day readmission rate for patients with a high risk for readmission disease state significantly decreased from 17.5% to 15.5% in the pre-expansion to postexpansion phase, respectively (p = .003). Discharge medication reconciliation capture rate increased from 28% pre-expansion to 35% postexpansion. After expansion, the number of DMR interventions reported by pharmacists increased 2.93 times.

Conclusion:
Expansion of pharmacist-led DMR as a form of transitions of care significantly decreased 30-day readmission rate for high risk of readmission disease groups.
Clinician Perspectives on How to Hold Earlier Discussions About Palliative and End-of-Life Care With Chronic Obstructive Pulmonary Disease Patients
Authors: Tavares Nuno , Jarrett Nikki , Wilkinson Tom , Hunt Katherine 
Published: March 2022

Chronic obstructive pulmonary disease is associated with progressive symptoms and increased treatment burden, especially at the end of life. However, most patients do not receive palliative care until late in their lives or discuss their end-of-life preferences with clinicians. This study explored clinicians' perspectives on the timing and nature of palliative care discussions.
Qualitative interviews were conducted with 7 physicians and 7 nurses working in primary and secondary care settings. Data were analyzed using a thematic analysis. Participants advocated for early, gradual, and informed palliative and future care discussions, because these discussions were thought to be less traumatic and better accepted by patients. Despite this, patient- and clinician-related barriers severely affected clinicians' ability to start discussions at earlier stages. Participants felt many patients were not ready for these discussions and feared damaging hope if the subject was broached. Therefore, clinicians delayed discussions until patients approached the end of life.
Stand-alone conversations about and near the end of life were described as current practice; however, clinicians believed these discussions reduced patients' hope and were potentially upsetting. Instead, individualized early, regular, and gradual discussions about immediate and long-term care plans were thought to be less negative and be better accepted.
Circulating Plasma Epstein-Barr Virus DNA Load During the Follow-up Periods Predicts Recurrence and Metastasis in Nasopharyngeal Carcinoma
Authors: He Sha-sha , Wang Yan , Yang Yun-ying , Niu Shao-qing , Zhu Mei-yan , Lu Li-xia , Chen Yong 
Published: March 2022

Background
Epstein-Barr virus DNA (EBV DNA) load has been identified as a prognostic factor in nasopharyngeal carcinoma (NPC), whereas the dynamic changes in the long period have not been explored. In this study, we evaluated EBV DNA kinetics and its role in the survival.

Methods
We conducted a retrospective review of 900 NPC patients. Plasma EBV DNA levels were measured at various time points after treatment. The correlations of EBV kinetics with recurrence and metastasis were analyzed. After stratifying patients according to the EBV results, survival was compared using Kaplan-Meier estimates. Twelve- and 24-month landmark analyses for overall survival (OS) data were performed according to the EBV groups.

Results
Patients with post-EBV of less than 2500 copies/mL achieved better survival than did those with higher ones. Furthermore, patients with continuously elevated EBV DNA expressed significantly poorer OS (hazard ratio [HR], 2.542, 95% confidence interval [CI], 2.077–3.111; P < 0.001), distant metastasis-free survival (HR, 2.970; 95% CI, 2.392–3.687; P < 0.001), locoregional-free survival (HR, 1.699; 95% CI, 1.072–2.692; P = 0.013), and progression-free survival (HR, 2.535; 95% CI, 1.987–3.233; P < 0.001) than did patients with continuously normal EBV or those with elevated levels at any time point. The 5-year OS with elevated EBV was lower than that of the remission group by using the 12- and 24-month landmark analysis.

Conclusions
Elevated EBV DNA after treatment was a better predictive indicator of survival than the baseline concentrations. Furthermore, continuously elevated EBV DNA after treatment indicated recurrence, metastasis, and unfavorable prognosis for NPC. In addition, there were consistent patterns of EBV DNA kinetics during long-term follow-up, which warrant further study.
Maritimibacter dapengensis sp. nov., a poly-β-hydroxyalkanoates-producing bacterium isolated from sediment of the Dapeng peninsula (Guangdong, China)
Authors: Yu Sheng-yang , Zheng Wei-shuang , Huang Yi 
Published: March 2022

A Gram-negative, obligate aerobic, non-motile, rod-shaped bacterium lacking a flagellum, was isolated from sediment sampled at the Dapeng peninsula of Shenzhen, Guangdong, China, and designated strain DP4N28-5T. Growth of strain DP4N28-5T occurred at 15–45 °C (optimum at 30 °C), pH 6.0–8.0 (optimum at 6.0) and in 2.0–10.0 % NaCl (w/v; optimum at 2.0–3.0 %). The 16S rRNA gene sequence analysis revealed that strain DP4N28-5T was most closely related to

Maritimibacter alkaliphilus

DSM 100037T (97.6 %; sequence similarity). The strain synthesized a trace amount of poly-β-hydroxybutyrate. The dominant cellular fatty acids were summed feature 8 (C18 : 1
ω6c and/or C18 : 1
ω7c), C16 : 0, 11-mehtyl C18 : 1
ω7c and C16 : 0 2-OH. The major polar lipids included phosphatidylethanolamine, phosphatidylglycerol, phosphatidylmethylethanolamine, one unidentified aminophospholipid, three unidentified aminolipids and four unidentified lipids. The respiratory quinone was Q-10. The DNA G+C content was 62.0 mol% and the estimated genome size was 3.9 Mbp. The calculated average nucleotide value between strain DP4N28-5T and

M. alkaliphilus

DSM 100037T was 78.1 %. The phenotypic, genotypic and chemotaxonomic differences between strain DP4N28-5T and its phylogenetic relatives indicate that DP4N28-5T represents a novel species in the genus

Maritimibacter

, for which the name Maritimibacter dapengensis sp. nov. is proposed. The type strain is DP4N28-5T (=MCCC 1K05640T=KCTC 82805T). The description of genus

Maritimibacter

was emended to include this new species.
Positive selection in gamete interaction proteins inCarnivora
Authors: Pisciottano Francisco , Campos Clara , Penna Clementina , Bruque Carlos David , Gabaldón Toni , Saragüeta Patricia 
Published: March 2022

AbstractThe absence of robust interspecific isolation barriers among pantherines, including the iconic South American jaguar (Panthera onca), led us to study molecular evolution of typically rapidly evolving reproductive proteins within this subfamily and related groups. In this study, we delved into the evolutionary forces acting on the Zona Pellucida (ZP) gamete interaction protein family and the sperm-oocyte fusion protein pair IZUMO1-JUNO across theCarnivoraorder, distinguishing betweenCaniformiaandFeliformiasuborders and anticipating few significant diversifying changes in thePantherinaesubfamily. A chromosome-resolved jaguar genome assembly facilitated coding sequences, enabling the reconstruction of protein evolutionary histories. Examining sequence variability across more than 30 Carnivora species revealed thatFeliformiaexhibited significantly lower diversity compared to its sister taxa,Caniformia. Molecular evolution analyses of ZP2 and ZP3, subunits directly involved in sperm-recognition, unveiled diversifying positive selection inFeliformia,Caniformia, andPantherinae, although no significant changes were linked to sperm binding. Structural cross-linking ZP subunits, ZP4, and ZP1 exhibited lower levels or complete absence of positive selection. Notably, the fusion protein IZUMO1 displayed prominent positive selection signatures and sites in basal lineages of bothCaniformiaandFeliformia, extending along theCaniformiasubtree but absent inPantherinae. Conversely, JUNO did not exhibit any positive selection signatures across tested lineages and clades. Eight Caniformia-specific positive selected sites in IZUMO1 were detected within two JUNO-interaction clusters. Our findings provide for the first time insights into the evolutionary trajectories of ZP proteins and the IZUMO1-JUNO gamete interaction pair within theCarnivoraorder.
Global, regional, and cryptic population structure in a high gene-flow transatlantic fish
Authors: Jansson Eeva , Faust Ellika , Bekkevold Dorte , Quintela María , Durif Caroline , Halvorsen Kim Tallaksen , Dahle Geir , Pampoulie Christophe S. , Kennedy James , Whittaker Benjamin , Unneland Laila , André Carl , Glover Kevin A. 
Published: March 2022

1AbstractLumpfish (Cyclopterus lumpus) is a transatlantic marine fish displaying large population sizes and a high potential for dispersal and gene-flow. These features are expected to result in weak population structure. Here, we investigated population genetic structure of lumpfish throughout its natural distribution in the North Atlantic using two approaches: I) 4393 genome wide SNPs and 95 individuals from 10 locations, and II) 139 discriminatory SNPs and 1,669 individuals from 40 locations. Both approaches identified extensive population genetic structuring with a major split between the East and West Atlantic and a distinct Baltic Sea population, as well as further differentiation of lumpfish from the English Channel, Iceland, and Greenland. The targeted discriminatory loci displayed ∼2-5 times higher divergence than the genome wide approach, revealing further evidence of local population substructures. Lumpfish from Isfjorden in Svalbard were highly distinct but resembled most fish from Greenland. The Kattegat area in the Baltic transition zone, formed a previously undescribed distinct genetic group. Also, further subdivision was detected within North America, Iceland, West Greenland, Barents Sea, and Norway. Although lumpfish have considerable potential for dispersal and gene-flow, the observed high levels of population structuring throughout the Atlantic suggests that this species displays natal homing and potentially local populations with adaptive differences. This fine-scale population structure calls for consideration when defining management units for lumpfish fishing stocks and in decisions related to sourcing and moving lumpfish for farming and cleaner fish use.