bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID-19 Vaccination May Not Increase Rates of Corneal Graft Rejection
Authors: Busin Massimo , Zauli Giorgio , Pellegrini Marco , Virgili Gianni , Yu Angeli Christy 
Published: August 2022

Purpose:
The aim of the study was to present the rates of rejection from 2018 to 2021 and evaluate the purported association between COVID-19 vaccination and corneal graft rejection.

Methods:
Cases of corneal graft rejection diagnosed between January 2018 and December 2021 were reviewed. The conditional Poisson regression model of the self-controlled case series method was used to estimate the incidence risk ratio of graft rejection after COVID-19 vaccination risk period compared with the control period. Based on outcomes of eyes that underwent keratoplasty from January 2018 to December 2020, Cox proportional hazard models were fitted with previous COVID-19 vaccination as a time-varying covariate.

Results:
Over the past 4 years, the annual tally of diagnosed cases of graft rejection (19 cases in year 2018, 19 cases in year 2019, 21 cases in year 2020, and 18 cases in year 2021) has remained relatively stable. Using the conditional Poisson regression analysis, no significant increase in the incidence rate of rejection in the risk period after COVID-19 vaccination was found (incidence risk ratio = 0.56, 95% confidence interval [CI] = 0.13–2.28, P = 0.70). Fitted as a time-varying covariate, previous COVID-19 vaccination was not associated with graft rejection in both unadjusted (hazard ratio =0.77, 95% CI = 0.29–5.46, P = 0.77) and adjusted Cox models (hazard ratio = 0.75, 95% CI = 0.10–5.52, P = 0.78).

Conclusions:
No notable increase in rates of corneal graft rejection was noted in year 2021 when COVID-19 vaccination was broadly implemented. The apparent temporal relationship between COVID vaccination and corneal graft rejection may not represent a causative association.
“Groove and Peel” Deep Anterior Lamellar Keratoplasty: How Deep Can You Go?
Authors: Son Hyeck-Soo , Rigi Mohammed , Srikumaran Divya , Eberhart Charles G. , Jun Albert S. , Soiberman Uri S. 
Published: August 2022

Purpose:
The aim of the current research was to measure the thickness of the residual central corneal bed after performing the manual “Groove and Peel” deep anterior lamellar keratoplasty (GP-DALK) technique on human cadaveric eyes.

Methods:
The manual GP-DALK technique was performed on 6 human cadaver eyes by an experienced corneal surgeon. After surgery, the eye globes were fixed in 10% buffered formalin and embedded in paraffin. For each eye, 4-μm-thick hematoxylin and eosin sections involving the pupillary axis were obtained and examined. Using an image-processing software, 2 observers measured the corneal thickness of the residual central corneal bed and the peripheral corneal rims.

Results:
The overall mean central corneal bed thickness was 35.5 ± 12.9 μm, whereas the mean right and left peripheral rim thicknesses were 993.0 ± 141.1 and 989.3 ± 147.1 μm, respectively (P = 0.0006). In most corneas, the level of dissection reached almost to the pre-Descemetic collagen (Dua) layer.

Conclusions:
The GP-DALK technique is effective in removing most of the corneal stroma and may be non-inferior to “big-bubble” deep anterior lamellar keratoplasty in some cases.
Clinical and Microbiological Spectra and Therapeutic Outcomes of Polymicrobial Keratitis
Authors: Rathi Anubha , Ramazanova Khuraman , Murthy Somasheila I. , Mohamed Ashik , Joseph Joveeta , Doctor Mariya Bashir , Pandey Suchita , Rathi Varsha M. 
Published: August 2022

Purpose:
The aim of this study was to evaluate the risk factors, microbiology, and treatment outcomes of polymicrobial keratitis (PMK).

Methods:
We retrospectively analyzed 65 patients diagnosed with PMK between 2016 and 2019. The clinical and microbiological characteristics and outcomes were evaluated. The primary outcome measure was clinical resolution of keratitis. Absolute success (group A) was defined as resolution of infection with medical treatment, qualified success (group B) was resolution with medical therapy and additional minor procedures, and failure (group C) was defined as worsening of infection and presence of corneal melting or perforation requiring therapeutic penetrating keratoplasty or evisceration.

Results:
Of 4764 cases of microbial keratitis, PMK was identified in 65 eyes of 65 patients (1.36%). Infiltrate was central in 60% (39 eyes). Predisposing factors were higher in group C and included uncontrolled diabetes mellitus in 25% (7/28), history of trauma/foreign body in 57.1% (16/28), and poor presenting visual acuity (0.9 for group A vs. 1.79 for group B vs. 3.00 logarithm of the minimum angle of resolution for group C; P = 0.02). Microbiological profiling revealed that a majority (95%: 62/65) had bacterial with fungal keratitis. High fluoroquinolone resistance was noted (57%; 34/59). Absolute success was achieved in 28.3% (17/60), qualified success in 16.6% (10/60), and treatment failure was noted in 55% (33/60). The final best corrected visual acuity in group A was significantly better than that in group B and C (0.44 vs. 3.00 vs. 2.78; P < 0.001).

Conclusions:
PMK is extremely rare but responds poorly to medical therapy. Bacterial with fungal etiology is predominant. Early surgical intervention to improve overall outcome is advocated.
Unbiased analysis of the dorsal root ganglion after peripheral nerve injury: no neuronal loss, no gliosis, but satellite glial cell plasticity
Authors: Schulte Annemarie , Lohner Hannah , Degenbeck Johannes , Segebarth Dennis , Rittner Heike L. , Blum Robert , Aue Annemarie 
Published: August 2022

Abstract
Pain syndromes are often accompanied by complex molecular and cellular changes in dorsal root ganglia (DRG). However, the evaluation of cellular plasticity in the DRG is often performed by heuristic manual analysis of a small number of representative microscopy image fields. In this study, we introduce a deep learning–based strategy for objective and unbiased analysis of neurons and satellite glial cells (SGCs) in the DRG. To validate the approach experimentally, we examined serial sections of the rat DRG after spared nerve injury (SNI) or sham surgery. Sections were stained for neurofilament, glial fibrillary acidic protein (GFAP), and glutamine synthetase (GS) and imaged using high-resolution large-field (tile) microscopy. After training of deep learning models on consensus information of different experts, thousands of image features in DRG sections were analyzed. We used known (GFAP upregulation), controversial (neuronal loss), and novel (SGC phenotype switch) changes to evaluate the method. In our data, the number of DRG neurons was similar 14 d after SNI vs sham. In GFAP-positive subareas, the percentage of neurons in proximity to GFAP-positive cells increased after SNI. In contrast, GS-positive signals, and the percentage of neurons in proximity to GS-positive SGCs decreased after SNI. Changes in GS and GFAP levels could be linked to specific DRG neuron subgroups of different size. Hence, we could not detect gliosis but plasticity changes in the SGC marker expression. Our objective analysis of DRG tissue after peripheral nerve injury shows cellular plasticity responses of SGCs in the whole DRG but neither injury-induced neuronal death nor gliosis.
Safety and Feasibility of Photodynamic Therapy for Ablation of Peripheral Lung Tumors
Authors: Bansal Sandeep , Bechara Rabih I. , Patel Jiten D. , Mehta Hiren J. , Ferguson J. Scott , Witt Benjamin L. , Murgu Septimiu D. , Yasufuku Kazuhiro , Casal Roberto F. 
Published: August 2022

Background:
Newer navigational bronchoscopy technologies render peripheral lung lesions accessible for biopsy and potential treatment. We investigated whether photodynamic therapy (PDT) delivered via navigational bronchoscopy is feasible and safe for ablation of peripheral lung tumors.

Methods:
Two studies evaluated PDT in patients with solid peripheral lung tumors followed by clinical follow-up (nonresection study, N=5) or lobectomy (resection study, N=10). Porfimer sodium injection was administered 40 to 50 hours before navigational bronchoscopy. Lesion location was confirmed by radial probe endobronchial ultrasonography. An optical fiber diffuser was placed within or adjacent to the tumor under fluoroscopic guidance; laser light (630 nm wavelength) was applied at 200 J/cm of diffuser length for 500 seconds. Tumor response was assessed by modified Response Evaluation Criteria in Solid Tumors at 3 and 6 months postprocedure (nonresection study) and pathologically (resection study).

Results:
There were no deaths, discontinuations for adverse events, or serious or grade ≥3 adverse events related to study treatments. Photosensitivity reactions occurred in 8 of 15 patients: 6 mild, 1 moderate, 1 severe (elevated porphyrins noted in blood after treatment). Among 5 patients with clinical follow-up, 1 had complete response, 3 had stable disease, and 1 had progressive disease at 6 months follow-up. Among 10 patients who underwent lobectomy, 1 had no evidence of tumor at resection (complete response), 3 had 40% to 50% tumor cell necrosis, 2 had 20% to 35%, and 4 had 5% to 10%.

Conclusion:
PDT for nonthermal ablation of peripheral lung tumors was feasible and safe in this small study. Further study is warranted to evaluate efficacy and corroborate the safety profile.
Endoscopic Endonasal Eustachian Tube Obliteration as a Treatment for Tension Pneumocephalus After Translabyrinthine Resection of Vestibular Schwannoma
Authors: Ji Keven S. Y. , Rimmer Ryan , Dogan Aclan , Cetas Justin S. , Ciporen Jeremy N. , Sanusi Olabisi , Gupta Sachin , Geltzeiler Mathew 
Published: August 2022

Objective
Cerebrospinal fluid leak and pneumocephalus are rare but potentially devastating complications associated with translabyrinthine resection of cerebellopontine angle masses. Persistent pneumocephalus despite proximal eustachian tube (ET) obliteration is rare. We describe, to our knowledge, the first report of successful management of tension pneumocephalus by endoscopic endonasal ET obliteration using a novel V-loc (Covidien; Medtronic, Minneapolis, MN) suture technique.

Patients
A 63-year-old man presented with altered mental status 10 months after translabyrinthine excision of a left cerebellopontine angle vestibular schwannoma measuring 2.8 × 2.9 × 3.3 cm. Computed tomography demonstrated diffuse ventriculomegaly and new pneumocephalus along the right frontal lobe, lateral ventricles, and third ventricle, and air within the left translabyrinthine resection cavity.

Intervention
The patient underwent left-sided endoscopic endonasal ET obliteration using 2-0, 9-inch V-loc suture.

Main Outcome Measure
Postoperatively, the patient's mental status improved with a decrease in size of the lateral and third ventricles on computed tomography.

Conclusion
Endoscopic endonasal ET obliteration, a technique previously applied to recalcitrant cerebrospinal fluid leaks, is a safe and reasonable alternative to reentering the original surgical site for patients with pneumocephalus after lateral skull base surgery. Utilizing a V-loc suture for this technique instead of a traditional suture may improve procedural ease and speed.
Frailty Is Superior to Age for Predicting Readmission, Prolonged Length of Stay, and Wound Infection in Elective Otology Procedures
Authors: Stidham Katrina , Naftchi Alexandria F. , Spirollari Eris , Vaserman Grigori , Vazquez Sima , Das Ankita , Colasacco Christine , Culbertson Sara , Ng Christina , Graifman Gillian , Beaudreault Cameron , Lui Aiden K. , Dominguez Jose F. , Kazim Syed Faraz , Schmidt Meic , Bowers Christian A. 
Published: August 2022

Objective
To determine the predictive ability of the 5-point modified frailty index relative to age in elective otology patients.

Study Design
Retrospective database analysis.

Setting
Multicenter, national database of surgical patients.

Patients
We selected all elective surgical patients who received tympanoplasty, tympanomastoidectomy, mastoidectomy, revision mastoidectomy, and cochlear implant procedures from 2016 to 2019 from the National Surgical Quality Improvement database.

Interventions
Therapeutic.

Main Outcome Measures
Readmission rates, discharge disposition, reoperation rates, and extended length of hospital stay.

Results
Utilizing receiver operating characteristics with area under the curve (AUC) analysis, nonrobust status was determined to be a superior predictor relative to age of readmission (AUC = 0.628 [p < 0.001] versus AUC = 0.567 [p = 0.047], respectively) and open wound infection relative to age (AUC = 0.636 [p = 0.024] versus AUC = 0.619 [p = 0.048], respectively). Nonrobust otology patients were more likely to have dyspnea at rest and an American Society of Anesthesiology score higher than 2 before surgery (odds ratios, 13.304 [95% confidence interval, 2.947–60.056; p < 0.001] and 7.841 [95% confidence interval, 7.064–8.704; p < 0.001], respectively).

Conclusion
Nonrobust status was found to be a useful predictor of readmission and prolonged length of stay in patients undergoing elective otology procedures, which generally have low complication rate. Given the aging population and corresponding increase in otology disease, it is important to use age-independent risk stratification measures. Frailty may provide a useful risk stratification tool to select surgical candidates within the aging population.
Etiologies of Proctitis at a Sexual Health Clinic in Seattle, Washington From 2011 to 2021
Authors: Kumbhakar Raaka , Barbee Lindley A. , Berzkalns Anna , Herrmann Susannah , Ramchandani Meena S. , Golden Matthew R. , Dombrowski Julia C. 
Published: August 2022

Abstract
We analyzed microbiologic etiologies of proctitis among patients seen in an urban sexual health clinic during 2011 to 2021. Among 759 cases, 179 (24%) tested positive for Neisseria gonorrhoeae, 171 (23%) for Chlamydia trachomatis, 21 (3%) for herpes simplex virus, 30 (4%) for syphilis, and 73 (10%) for multiple pathogens; no pathogen was identified in 425 (56%).
Intermediate Outcomes of Orbital Wall Reconstruction Using Different Alloplastic Materials: Which Is Ideal?
Authors: Kohyama Keishi , Ishihara Takuma , Tsuboi Yoshiki , Morishima Yoko 
Published: August 2022

Background:
Despite the popularity and superiority of resorbable alloplastic materials in orbital fracture reconstruction, it is unclear whether the reconstructed wall is maintained after implant resorption. Although unsintered hydroxyapatite/poly-L-lactide (u-HA/PLLA) is one such material, it is different from conventional materials for the replacement of natural bones. Therefore, this study investigated the intermediate-term safety and efficacy of u-HA/PLLA implants compared to those of implants made with other alloplastic materials.

Methods:
We retrospectively analyzed 240 eligible patients who underwent orbital fracture reconstruction with one alloplastic material between January 2006 and October 2018. Materials used for treatment were as follows: u-HA/PLLA sheet in 101 patients; u-HA/PLLA mesh in 38 patients; poly-L-lactic acid (PLA)/poly-glycolic acid (PGA) mesh in 47 patients; silicone sheet in 35 patients; and titanium mesh in 19 patients. Intermediate-term follow-up was performed for a median duration of 48.2 months. A chart review was performed. Postoperative complications and factors affecting them were studied. Reconstructed area deformities were assessed using computed tomography.

Results:
Postoperative complications occurred significantly more frequently in patients reconstructed with the silicone sheet than in those reconstructed with the u-HA/PLLA sheet. Deformities were found for the silicone sheet (28.6%) and PLA/PGA mesh (31.9%). These deformity rates were significantly higher than those for the u-HA/PLLA sheet.

Conclusions:
Compared to other alloplastic materials, u-HA/PLLA has low rates of postoperative complications and reconstructed area deformities. Because of its complete absorption, clinicians should consider using u-HA/PLLA as an alloplastic material for orbital wall reconstruction.
Higher Soluble CD163 in Blood Is Associated With Significant Depression Symptoms in Men With HIV
Authors: Anderson Albert M. , Bhondoekhan Fiona , Curanovic Dusica , Connelly Margery A. , Otvos James D. , Post Wendy S. , Michos Erin D. , Stosor Valentina , Levine Andrew , Seaberg Eric , Weinstein Andrea M. , Becker James T. 
Published: August 2022

Background:
People with HIV (PWH) are more likely to experience depression, a highly morbid disease. More evidence is needed to better understand mechanisms of depression in PWH. We evaluated a panel of blood biomarkers in relation to depression symptoms in the Multicenter AIDS Cohort Study (MACS).

Setting:
Four sites in the United States.

Methods:
A cross-sectional analysis was performed within the MACS, a prospective study of cisgender men with and without HIV. Depression was assessed with the Center for Epidemiological Studies-Depression Scale, and six blood biomarkers were measured: GlycA, high sensitivity C-reactive protein (CRP), interleukin-6, CCL2, soluble CD14 (sCD14), and soluble CD163 (sCD163). Using univariable and multivariable logistic regression, the biomarkers and other factors were evaluated in relation to significant depression symptoms (SDS) by Center for Epidemiological Studies-Depression score ≥16.

Results:
784 men were analyzed; most of whom (63%) were PWH. PWH were more likely to have SDS (32% vs. 21%). In univariable analysis, higher GlycA, CRP, and sCD163 concentrations were associated with SDS. In multivariable analysis, however, only higher sCD163 concentration was associated with SDS (odds ratio = 2.30, 95% CI = 1.11 to 4.76). This relationship was driven by the PWH group (odds ratio = 2.72, 95% CI = 1.12 to 6.58) and remained significant when controlling for antidepressant use. Lack of college education was also associated with SDS.

Conclusions:
Higher sCD163, a marker of macrophage activation, was significantly associated with significant depression symptoms in the MACS. Further research on this biomarker and macrophage activation in general is warranted to better understand and treat depression in PWH.
Economic Well-being and Associated Mediating Pathways to Improved Antiretroviral Therapy Adherence Among Adolescents Living With HIV: A Prospective Cohort Study in South Africa
Authors: Steinert Janina Isabel , Shenderovich Yulia , Smith Michael , Zhou Siyanai , Toska Elona , Cluver Lucie 
Published: August 2022

Background:
Adolescents living with HIV exhibit lower levels of adherence to antiretroviral therapy (ART) than other age groups. Poverty is a key barrier to ART adherence. This study aims at understanding how alleviating poverty through structural and internal pathways can help increase ART adherence among adolescents.

Setting:
Eastern Cape province, South Africa.

Methods:
One thousand forty-six adolescents living with HIV were recruited from 53 public health care facilities and interviewed at 3 data collection waves with a retention rate of 89% and a mortality rate of 3%. Data were collected by face-to-face, device-assisted interviews. Hybrid probit regressions and a structural equation path analysis were used to estimate the association between poverty reduction (increased access to basic necessities) and the pathways by which it could improve ART adherence.

Results:
Self-reported ART adherence ranged from an average of 66% (n = 615) at baseline to 75% (n = 700) in the last wave. Within-person and between-person improvements in economic well-being were associated with significant increases in adolescent ART adherence. On average, adolescents with access to 3 additional basic needs experienced a 4 percentage-point increase in the probability of ART adherence. Structural pathways to improved ART adherence included participants having enough money to travel to the clinic and sufficient food to eat when taking medication. Internal pathways included improved psychological well-being and reduced internalized HIV stigma.

Conclusion:
Poverty reduction programs such as HIV-sensitive social protection can address structural and psychological pathways to increase ART adherence among economically disadvantaged adolescents by incentivizing demand-side interventions and the provision of quality essential services.
Dynamics of Total and Intact HIV-1 DNA in Virologically Suppressed Patients Switching to DTG-Based or ATV-Based Dual Therapy
Authors: Dragoni Filippo , Rossetti Barbara , Lombardi Francesca , Spertilli Raffaelli Chiara , Bartolini Niccolò , Giammarino Federica , Moschese Davide , Di Giambenedetto Simona , Fabbiani Massimiliano , De Luca Andrea , Vicenti Ilaria , Zazzi Maurizio , Saladini Francesco 
Published: August 2022

Background:
Clinical trials have demonstrated noninferior viral suppression rates of selected 2-drug regimens (2DRs) over standard 3-drug regimens (3DRs). However, the effect of simplification to 2DRs on HIV-1 reservoir remains to be fully assessed.

Setting:
Retrospective analyses of samples of virologically suppressed people living with HIV remaining on the same 3DRs or switching to DTG + 3TC or ATV/r + 3TC 2DRs.

Methods:
Whole blood samples were collected at enrollment and after 48 weeks. Total HIV-1 DNA (tDNA) and intact HIV-1 DNA (iDNA) were quantified by droplet digital polymerase chain reaction and intact proviral DNA assay, respectively. Statistical analysis was performed to identify associations among variables, and multiple linear regression was used to analyze potential predictors of tDNA and iDNA changes over time.

Results:
Forty-seven individuals were switched to DTG + 3TC 2DR (N = 23) and ATV/r + 3TC 2DR (N = 24), while 18 remained on 3DRs. tDNA did not change either in the overall population or in the 3DR and 2DR groups. iDNA decreased significantly in the whole data set and in the overall 3DR and 2DR groups (P = 0.001, P = 0.039 and P = 0.009, respectively). iDNA, but not tDNA, was inversely correlated with the time of viral suppression (P = 0.002) and time under antiretroviral therapy (P = 0.006). Higher nadir CD4+ T-cell counts (P = 0.001) and lower zenith viral load (P = 0.02) showed an association with the decrease of iDNA, but not with tDNA.

Conclusions:
Both tDNA and iDNA dynamics supported noninferior efficacy of 2DRs over 3DRs. iDNA could be more informative than tDNA in analyzing the dynamics of the HIV-1 reservoir under different treatment strategies.