bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extent of Low-density Lipoprotein Cholesterol Reduction and All-cause and Cardiovascular Mortality Benefit: A Systematic Review and Meta-analysis
Authors: Ennezat Pierre Vladimir , Guerbaai Raphaëlle-Ashley , Maréchaux Sylvestre , Le Jemtel Thierry H. , François Patrice 
Published: August 2022

Abstract:
Lipid-modifying agents steadily lower low-density lipoprotein cholesterol (LDL-C) levels with the aim of reducing mortality. A systematic review and meta-analysis were conducted to determine whether all-cause or cardiovascular (CV) mortality effect size for lipid-lowering therapy varied according to the magnitude of LDL-C reduction. Electronic databases were searched, including PubMed and ClinicalTrials.gov, from inception to December 31, 2019. Eligible studies included randomized controlled trials that compared lipid-modifying agents (statins, ezetimibe, and PCSK-9 inhibitors) versus placebo, standard or usual care or intensive versus less-intensive LDL-C–lowering therapy in adults, with or without known history of CV disease with a follow-up of at least 52 weeks. All-cause and CV mortality as primary end points, myocardial infarction, stroke, and non-CV death as secondary end points. Absolute risk differences [ARD (ARDs) expressed as incident events per 1000 person-years], number needed to treat (NNT), and rate ratios (RR) were assessed. Sixty randomized controlled trials totaling 323,950 participants were included. Compared with placebo, usual care or less-intensive therapy, active or more potent lipid-lowering therapy reduced the risk of all-cause death [ARD −1.33 (−1.89 to −0.76); NNT 754 (529–1309); RR 0.92 (0.89–0.96)]. Intensive LDL-C percent lowering was not associated with further reductions in all-cause mortality [ARD −0.27 (−1.24 to 0.71); RR 1.00 (0.94–1.06)]. Intensive LDL-C percent lowering did not further reduce CV mortality [ARD −0.28 (−0.83 to 0.38); RR 1.02 (0.94–1.09)]. Our findings indicate that risk reduction varies across subgroups and that overall NNTs are high. Identifying patient subgroups who benefit the most from LDL-C levels reduction is clinically relevant and necessary.
GDF11 Is a Novel Protective Factor Against Vascular Calcification
Authors: Sheng Ying , Zhang Chenming , Liu Yehong , Xu Baida , Jin Tianhui , Ye Ting , Liu Jie , Wu Gangyong , Chen Liang , Zong Gangjun 
Published: August 2022

Abstract:
Vascular calcification (VC) occurs via an active cell-mediated process, which involves osteogenic differentiation, apoptosis, and phenotypic transformation of vascular smooth muscle cells (VSMCs). As a member of the transforming growth factor-β family, growth differentiation factor 11 (GDF11) can inhibit apoptosis and osteogenic differentiation and maintain the stability of atherosclerotic plaques. In this study, coronary artery calcium score (CACS) of participants with GDF11 measurements was measured using computed tomography angiography and was scored according to the Agatston score. β-glycerophosphate (10 mM), dexamethasone (100 nM), and l-ascorbic acid (50 µg/mL) [osteogenic medium (OM)] were used to induce calcification of human aortic smooth muscle cells. We found that CACS was negatively correlated with serum GDF11 levels in patients and GDF11 was a strong predictor of elevated CACS (OR = 0.967, 95% CI: 0.945–0.991; P = 0.006), followed by age (OR = 1.151, 95% CI: 1.029–1.286; P = 0.014), triglycerides (OR = 4.743, 95% CI: 1.170–19.236; P = 0.029), C-reactive protein (OR = 1.230, 95% CI: 1.010–1.498; P = 0.04), and hypertension (OR = 7.264, 95% CI: 1.099–48.002; P = 0.04). Furthermore, exogenous GDF11 inhibited OM-induced calcification by inhibiting osteogenic differentiation, the phenotypic transformation and apoptosis of human aortic smooth muscle cells. Our study demonstrates that GDF11 plays a crucial role in reducing vascular calcification and serves as a potential intervention target to vascular calcification.
Systemic Delivery of Clopidogrel Inhibits Neointimal Formation in a Mouse Vein Graft Model
Authors: Shi LinSheng , Chen XiaoLi , Wang HuiMin , Xu YiMing , Din ShengGuang , Liu Jun , Zhang Qing , Zhang Li 
Published: August 2022

Abstract:
Clopidogrel inhibits platelet aggregation and has beneficial effects on patients undergoing coronary artery bypass grafting surgery, but it is unknown whether clopidogrel inhibits the neointima formation of grafted veins. In this study, we used a murine vein graft model to study the effect of clopidogrel on intima hyperplasia of the vein graft. Vein grafting was performed among C57BL/6J mice, immediately after surgery; 1 mg/kg clopidogrel and vehicle control were used to inject mice peritoneally daily for 2 weeks. As compared with the vehicle, clopidogrel significantly inhibited the neointima formation of vein grafts at 4 weeks after surgeries. The immunohistochemistry study showed that as compared with the vehicle, clopidogrel significantly decreased the rate of proliferating cell nuclear antigen–positive cells in the wall of vein grafts and significantly increased the expression of vascular smooth muscle cell (VSMC) contractile protein markers (α-smooth muscle actin, calponin, and SM22) within the neointima area of vein grafts. Clopidogrel significantly decreased the plasma interleukin 6 (IL-6) level at 1 week after surgery as compared with the vehicle. We isolated VSMCs from mouse aortic arteries. As compared with the vehicle, clopidogrel significantly inhibited thrombin-induced VSMC proliferation and migration, significantly decreased IL-6 mRNA expression and protein secretion, and increased intracellular cyclic adenosine monophosphate generation in a dose-dependent manner. In conclusion, systemic delivery of clopidogrel inhibits neointima formation of the mouse vein graft, the mechanisms of which are associated with its inhibitory effects on VSMC proliferation, migration, and the tendency to synthetic phenotype after vein graft surgery, reducing the expression of IL-6 and increasing the intracellular cyclic adenosine monophosphate level.
Increasing Collaboration between Headache Medicine and Plastic Surgery in the Surgical Management of Chronic Headache
Authors: Blake Pamela , ElHawary Hassan , Janis Jeffrey E. 
Published: August 2022

Introduction:
Chronic headache is one of the most disabling conditions afflicting humankind. The management of chronic headaches has, to date, been only partially successful. The goal of this paper is to highlight the importance of collaboration between surgeons and headache physicians in treating this condition.

Methods:
We present a narrative review of migraine pathophysiology, its medical and surgical treatment options, and the important role of collaboration between headache physicians and surgeons.

Results:
Migraine headaches can be treated with both medication-based regimens and surgery. Novel medications such monoclonal antibodies directed at the CGRP molecule or its receptor have recently been FDA approved as an effective treatment modality in chronic migraines. However, these medications are associated with a high cost, and there is a paucity in data regarding effectiveness compared to other treatment modalities. The pathophysiology of headache likely exists along a spectrum with peripheral — extracranial and meningeal — factors at one end and central — brain — factors at the other, with anatomic and physiologic connections between both ends. Recent evidence has clearly shown that surgical decompression of extracranial nerves improves headache outcomes. However, appropriate patient selection and preoperative diagnosis are of paramount importance to achieve excellent outcomes.

Conclusions:
Surgeons and headache physicians who are interested in providing treatment for patients with chronic headache should strive to form a close collaboration with each other in order to provide the optimal plan for migraine/headache patients.
Targeted Muscle Reinnervation Does Not Increase the Risk of Postsurgical Complication or Overall Cost
Authors: Deeyor Sorka T. , Kisana Haroon M. , Hui Clayton H. , Stecher Chad , Hustedt Joshua W. 
Published: August 2022

Background:
Targeted muscle reinnervation (TMR) has shown promise in reducing postsurgical limb pain in amputees. However, there has been little evidence on the increased risk of complications and cost as compared with traditional amputations. This study was designed to assess the rate of complications and healthcare costs between those treated with TMR and traditional amputations.

Methods:
Patients undergoing amputation were selected from the PearlDiver Mariner dataset and categorized into one of two treatment groups depending on the use of TMR versus traditional amputation. Rates of postsurgical complications and overall healthcare costs were compared between the two groups, while controlling for differences in patient demographics and comorbidities.

Results:
One hundred sixteen TMR procedures and 76,412 traditional amputations were included in the study. The rate of complications did not differ between groups, with a complication rate of 77% in the TMR and 87% in the traditional amputation groups. Overall healthcare costs also did not differ 1 year after surgery, with an average cost of $32,632 in the TMR group and $36,219 in the traditional amputation group.

Conclusions:
Amputees experience high rates of postsurgical complications, morbidity, and mortality. However, there is no increased risk of complications or cost with the use of TMR. TMR has the potential benefits of reducing overall postsurgical pain and reestablishing activities of daily living. Although TMR is more expensive up front, it may reduce the overall healthcare costs by reducing the need for subsequent care. Further work is needed in large, randomized trials to examine these findings.
A CASE OF EALES DISEASE OBSERVED BY WIDEFIELD OCTA
Authors: Nakamura Kosuke , Akiyama Hideo , Tokui Shunsuke , Saito Kazuma , Nitta Keisuke 
Published: August 2022

Abstract

Purpose:
To report a 30-year-old female with Eales disease, showing bilateral proliferative tissue. The retinal vessels were evaluated using widefield optical coherence tomography angiography (widefield OCTA), which has a wider angle of view compared to conventional instruments.

Methods:
A case report.

Results:
Widefield OCTA showed an extensive nonperfusion area and A-V shunt in both eyes, and a vascular structure in the left eye that appeared to be retinal neovascularization. Ultra-widefield fluorescein angiography revealed no filling delay in the early phase, a vast nonperfusion area from the mid-periphery to the ora serrata in bilateral eyes, and retinal neovascularization in the left eye. Based on the results of ultra-widefield angiography, OCTA examination and systemic examination, a diagnosis of Eales disease was finally made after all of the differential diseases had been excluded.

Conclusion:
In a patient with Eales disease, the peripheral nonperfusion area and retinal neovascularization that were consistent with the ultra-widefield angiography findings were noninvasively confirmed by widefield OCTA. Widefield OCTA is useful in the detection of peripheral changes of the fundus.
Evolution of the ‘omega sign’ on optical coherence tomography
Authors: Ramakrishnan Meera S. , Naguib Mina M. , Modi Yasha S. 
Published: August 2022

Abstract:

Purpose:
To present the early post-operative evolution of retained subretinal perfluoro-n-octane (PFO) as captured on OCT.

Methods:
Case report of a patient.

Results:
A 58-year-old woman was noted to have subretinal PFO after undergoing autologous retinal graft for macular hole closure under PFO tamponade. Serial OCT identified the subretinal PFO as early as the first postoperative day and demonstrates progressive consolidation and encapsulation of the PFO bubble by the surrounding outer retina.

Conclusion:
Subretinal PFO is usually seen several weeks in the postoperative course once the gas endotamponade has resorbed sufficiently for OCT imaging. In this case, PFO tamponade enabled its imaging early. Its subsequent evolution into the classic “omega sign” may suggest a granulomatous encapsulation of the PFO bubble.
A TITANIUM MACULAR BUCKLE IMPLANT DESIGNED FOR AN EASY PLACEMENT IN MYOPIC MACULAR HOLES
Authors: Akduman Levent 
Published: August 2022

Purpose:A new easy-to-place titanium macular buckle implant and the surgical technique for placing it in myopic macular holes are presented. A 60-year-old patient with pathologic myopia presented with macular holes in both eyes. The hole in the right eye was recurrent and long-standing since the initial diagnosis, which was over 5 years ago. He refused surgery for the better seeing left eye. The vision of the right eye was 20/200. The patient only wanted macular hole repair in the right eye if a macular buckle could be incorporated in the surgery.Methods:Because there was no commercially available macular buckle in the United States, a custom-made titanium buckle was designed and manufactured for this patient. In addition to the standard pars plana vitrectomy, internal limiting membrane peel, and gas tamponade, the titanium macular buckle was placed externally to provide indentation over the macula.Results:The titanium macular buckle provided approximately 1 mm of indentation, shortening the axial length from 28.88 mm to 27.94 mm. The macular hole was closed postoperatively. Postoperative best-corrected visual acuity was 20/200 at 1 month with no complications from the titanium macular buckle implant or the surgical technique. There was no improvement in the final visual acuity, which was attributed to foveal atrophy because of the long-standing nature of the macular hole.Conclusion:This titanium macular buckle implant designed for an easy placement could be an invaluable addition for surgical success in myopic macular pathologies, including myopic macular holes.
Repeatability of new optical biometer and agreement with 2 validated optical biometers, all based on SS-OCT
Authors: Galzignato Alice , Lupardi Enrico , Hoffer Kenneth J. , Barboni Piero , Schiano-Lomoriello Domenico , Savini Giacomo 
Published: August 2022

Purpose:
To evaluate the repeatability of the measurements provided by a new optical biometer (EyeStar 900) based on swept-source optical coherence tomography (SS-OCT) and their agreement with the measurements given by 2 validated biometers based on the same technology, the IOLMaster 700 and Argos.

Setting:
IRCCS G.B. Bietti Foundation, Rome, Italy.

Design:
Prospective evaluation of diagnostic test.

Methods:
In a series of unoperated eyes, 3 consecutive scans were acquired with the EyeStar 900, and 1 with the IOLMaster 700 and the Argos. The following biometry parameters were analyzed: axial length (AL), keratometry (K), corneal astigmatism, central corneal thickness, corneal diameter (CD), anterior chamber depth (ACD), lens thickness (LT), and lens tilting. Repeatability was assessed using test–retest variability, the coefficient of variation (CoV), and the intraclass correlation coefficient (ICC); agreement was based on the 95% limits of agreement.

Results:
56 eyes of 56 patients were analyzed. High repeatability was achieved for all measured parameters, as the CoV was <1% in most cases and ICC was >0.95 for all parameters. Good to high agreement was found among the measurements of the 3 optical biometers, although some statistically significant differences were detected between the EyeStar 900 and Argos (mean K, ACD, LT, and CD were higher with the Argos). The Argos measured a shorter AL in eyes >25 mm.

Conclusions:
The new generation SS-OCT EyeStar 900 optical biometer produces highly repeatable measurements that are in good agreement with those provided by 2 previously validated instruments.
Outcomes of LASIK versus PRK Enhancement in eye with prior cataract surgery
Authors: Rohlf Derek , La Nasa Anthony , Terveen Daniel , Shafer Brian , Thompson Vance , Berdahl John 
Published: August 2022

Purpose:
To compare post-enhancement visual acuity between patients that underwent post-cataract LASIK or PRK.

Setting:
A private, tertiary referral practice in Sioux Falls, South Dakota, USA.

Design:
Three-year, retrospective chart review.

Methods:
Patients that underwent post-cataract extraction excimer laser enhancement surgery targeted for emmetropia (±0.50 D). Post-enhancement uncorrected distance visual acuity (UDVA) and manifest refraction spherical equivalent (MRSE) was recorded for all available follow ups and compared for both groups.

Results:
822 post-cataract enhanced eyes (491 LASIK; 331 PRK). For patients with at least six months follow up, mean UDVA was 0.05 ± 0.13 logMAR in LASIK-enhanced patients and 0.15 ± 0.20 in PRK-enhanced patients (p<0.001). Mean absolute value MRSE was 0.22 ± 0.36 and 0.48 ± 0.62 for LASIK- and PRK-enhanced patients at or beyond six months, respectively (p<0.001). A total of 330 (67%) of LASIK-enhanced patients achieved 20/20 or better post-enhancement UDVA, compared to 142 (43%) PRK-enhanced patients (p<0.001). Controlling for pre-enhancement UDVA, LASIK-enhanced patients showed significantly better post-enhancement UDVA than PRK-enhanced patients, except in those with pre-enhancement vision of 20/20 or better, or those worse than 20/50. LASIK-enhanced virgin corneas had mean post-enhancement of 0.05 ± 0.14 UDVA compared to 0.13 ± 0.19 UDVA in PRK-enhanced virgin cornea patients (p<0.001).

Conclusion:
LASIK provides better and more predictable outcomes in UDVA than PRK in post-cataract enhancement patients, even when controlling for pre-enhancement visual acuity and prior ocular procedures.
Dual study on the sum-of-segments method for axial length measurement: is it better?
Authors: Olsen Thomas 
Published: August 2022

Abstract

Purpose:
To evaluate the sum-of-segments (SOS) method for optical axial length (AL) measurements.

Setting:
Department of Ophthalmology, University of Aarhus, Denmark and Private practice, Copenhagen ; Design: Retrospective, observational study.

Methods:
The present study involved 2 retrospective datasets. The first dataset comprised 1491 university cataract cases measured with the Lenstar LS900 (Haag-Streit AG) preoperatively as well as 1 – 4 months after surgery. The second dataset comprised 904 lens surgery cases with refractive follow-up to study the accuracy of IOL power calculation. The prediction accuracy was evaluated as the difference between the observed and the expected refraction.

Results:
The mean difference between the pre- and the postoperative AL readings was - 0.06 mm and - 0.020 mm for the standard and the SOS AL method, respectively, however with a larger variation for the SOS AL method (p < 0.01). For the second dataset, the SOS method was found to increase the accuracy of the SRK/T and the Holladay formulas. With the Olsen formula, the SOS method was found to be worse (p < 0.01). The highest accuracy was found using standard AL with the Olsen formula with a mean absolute error of 0.24 D and 89.8 % the cases within + 0.5 D.

Conclusions:
The SOS method improved the accuracy of the classical formulas probably because the optical path is a better representative of the true AL. The Olsen formula already incorporates an optical path correction and this may be the reason for the lack of improvement with the SOS method.
Long-Term Audiometric Outcomes of a Self-Crimping Stapes Prosthesis With CO2 Laser Stapedotomy
Authors: Shoman Nael M. 
Published: August 2022

Objective
To evaluate our experience with a self-crimping stapes prosthesis.

Study Design
Retrospective case review.

Setting
Tertiary referral center.

Patients
All patients diagnosed with otosclerosis who underwent surgery between June 2013 and June 2020. Inclusion criteria were 18 years or older, isolated stapes ankylosis, and at least 1 year of postoperative audiologic data.

Intervention(s)
CO2 laser stapedotomy undertaken by the same surgeon using the same CO2 laser stapedotomy technique and the same prosthesis.

Main Outcome Measure(s)
Preoperative and postoperative audiologic data including air-bone gap (ABG) measurements, average speech discrimination score and pure-tone averages (PTAs). Postoperative hearing assessments were performed at 3 weeks, 3 months, 6 months, 1 year, and annually thereafter.

Results
Two hundred fourteen patients were included in the study, of whom 17 had bilateral sequential surgery for a total of 231 ears. Mean preoperative air conduction-PTA was 58.8 dB and mean preoperative bone conduction-PTA 24.2 dB, a preoperative ABG of 34.6 dB. One year postoperatively, mean air conduction-PTA improved to 31.2 dB (p < 0.0001). ABG showed a significant improvement from 34.6 to 5.5 dB (p < 0.0001). Closure of the ABG to within 10 dB was achieved in 87% ears at 3 months, in 91% at 6 months, and in 93% at 1 year. There was no significant difference in preoperative and postoperative average speech discrimination score.

Conclusion
The current study demonstrates favorable audiologic outcomes in a large cohort of patients using a self-crimping stapes prosthesis. These results were stable for up to 7 years on follow-up.
Audiometric and Surgical Outcomes of a Novel Bone-Conduction Hearing Aid
Authors: Quimby Alexandra E. , Park Jino , Brant Jason A. , Eliades Steven J. , Kaufman Hannah S. , Bigelow Douglas C. , Ruckenstein Michael J. 
Published: August 2022

Objective
To report the audiometric and surgical outcomes of a series of patients having undergone implantation of a novel transcutaneous bone conduction implant (t-BCI).

Study Design
Retrospective case series.

Setting
Single academic tertiary referral center.

Patients
Adults (≥18 yr) implanted between December 1, 2019, and August 1, 2021, with audiometric data available before and after device implantation and a minimum of 4 weeks follow-up.

Interventions
Surgical t-BCI.

Main Outcome Measures
Change in aided pure tone average (PTA) after implantation. Secondary outcomes include average operative time, and adverse events.

Results
Twenty-three patients underwent implantation of the t-BCI via either a conventional or minimally invasive surgical approach. The most common indication for implantation was unilateral conductive hearing loss with a history of chronic otitis media. The mean operative time was 59 minutes. The mean preimplantation unaided air conduction PTA was 65 dB, and mean postimplantation was 27.2 dB. The mean change in PTA was 37.8 dB, which was significant (p < 0.0001). There were 30.4% of the patients that suffered from adverse events, the most common of which were pain (8.7%) and device-related complications (13%). One major adverse event occurred, involving magnet displacement that impaired device activation and required reoperation for replacement.

Conclusion
Forming the largest series of patients implanted with this t-BCI in the published literature, our data demonstrate that implantation of the device is feasible via either a traditional or minimally invasive surgical approach, with good audiometric benefit and a favorable safety profile.
A Single Gallbladder Fold Creates a Unique Visual and Temporal Pattern of Radiotracer Accumulation on Hepatobiliary Scintigraphy
Authors: Iyalomhe Osigbemhe , Rowe Steven P. 
Published: August 2022

Abstract
Duplication of the gallbladder represents a variant of anomalous biliary anatomy that is rarely encountered on hepatobiliary scintigraphy. We describe the case of 76-year-old man with a gallbladder fold mimicking duplication of the gallbladder or an associated choledochal cyst on scintigraphy. Correlative imaging with CT and ultrasound helped elucidate the true anatomy. This case demonstrates the type of difficult scintigraphic patterns that can arise with variant anatomy and the necessary role of cross-sectional, anatomic imaging in unraveling such situations.