bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mask-induced Artifact Impacts Intraocular Pressure Measurement Using Goldmann Applanation Tonometry
Authors: Davanian Arash M. , Donahue Sean P. , Mogil Rachel S. , Groth Sylvia L. 
Published: December 2020

Purpose:
The coronavirus (COVID-19) pandemic has impacted ophthalmology practices significantly. American Academy of Ophthalmology and Center for Disease Control guidelines suggest mandatory masking of patients and physicians during outpatient visits. We have recently become aware of a mask-induced phenomenon, whereby the intraocular pressure (IOP) as measured by Goldmann applanation tonometry (GAT) is artificially elevated due to mechanical interference from the mask.

Clinical Presentation:
A 37-year-old male with a history of primary open-angle glaucoma on triple therapy presented for a routine visit.

Clinical Findings:
When measuring IOP by GAT the right eye measured 16 mm Hg, but the left eye measured 20 mm Hg. The patient’s mask was noted to be touching the base of the sensor rod on the tonometer. This patient’s IOP was falsely elevated due to the lateral edge of his mask touching the base of the applanation tonometer, changing the relationship between the bi-prism tip and the weighted balance below, and eliminating the weighted balance from the pressure measuring mechanism. The patient’s mask was adjusted to ensure there was no touch and repeat measurement showed an IOP of 16 mm Hg in the left eye.

Conclusion:
Recognizing mask-induced alteration in IOP is essential as it could lead to unnecessary escalation of treatment. We recommend flattening the area of mask protrusion during applanation and ensuring that the sensor arm remains clear of the mask while the tonometer tip approaches the cornea, especially at the moment the mires become visible during corneal contact.
Central-most Visual Field Defects in Early Glaucoma
Authors: Chakravarti Tutul , Moghimi Sasan , De Moraes Carlos Gustavo , Weinreb Robert N. 
Published: December 2020

Précis:
This study demonstrates the substantial association between visual field (VF) defect within the central-most 4 points in 24-2 VF and the VF defect exhibited by 10-2 test pattern relative to the initial defect in 24-2 VF.

Purpose:
To evaluate the significance of central-most visual field defects (CMVFDs) in 24-2 VF in early glaucoma.

Methods:
This cross-sectional study examined 29 eyes of 28 glaucoma patients with CMVFDs. CMVFD was defined as a glaucomatous defect with at least 1 abnormal point at P<1% within the central 5 degrees on 3 consecutive 24-2 VF tests. 10-2 VFs were categorized into 3 groups by severity of pattern defects: deep arcuate, partial arcuate, and minimal defect. The deep arcuate group was interpreted as the most severe defect on the 10-2 VF. Mann-Whitney test was used to compare the perimetric parameters differences between 24-2 VFs with CMVFD and 10-2 VFs related to the initial defect.

Results:
CMVFD was observed in 82% eyes, predominantly in the superior hemifield (86%). Arcuate-like defects (72%) on the 10-2 VF were mostly in superior hemifield (82%). The deep arcuate group showed significantly worse mean deviation (MD) and pattern standard deviation (PSD), (MD= −9.1±4, PSD =10.7±2.1 dB), than partial arcuate and minimal defect groups (all P<0.001). Eyes with deep arcuate defect had severely depressed defect depth (−26 to −35 dB) and low sensitivity (<0 to 10 dB) at abnormal points in the central 5 degrees in 24-2 VF. A significant difference among deep arcuate, partial arcuate (P<0.001), and minimal defect groups (P<0.001) was observed at abnormal points’ threshold sensitivity and defect depth.

Conclusions:
Given the significance and effect of perimetric factors at abnormal test points in the central 5 degrees of 24-2 VFs, these eyes deserve attention to determine the severity of and functional impact on the CMVFD in early glaucoma by performing 10-2 test.
Drive-through Intraocular Pressure Checks During the COVID-19 Pandemic
Authors: Baughman Brittanie D. , Hansemann Beth K. , Shah Manjool M. , Weizer Jennifer S. 
Published: December 2020

Precis:
A drive-through clinic was created to obtain intraocular pressure measurements before a virtual visit with their provider, in order to provide care for patients in the Kellogg Glaucoma Clinic while minimizing risk of COVID-19 transmission.

Purpose:
The aim of this study was to establish a drive-through clinic model to provide glaucoma care for patients while minimizing the risk of COVID-19 transmission.

Patients and Methods:
A drive-through clinic was created by adapting a 1-lane, 1-way driveway adjacent to the Kellogg Eye Center building entrance. Patients were physicianselected from the Glaucoma Clinic at Kellogg Eye Center as existing patients who required intraocular pressure (IOP) checks and therapeutic management and were chosen based on their ability to be managed with an IOP measurement primarily. The entrance was otherwise closed to the public, allowing staff to utilize an adjacent vestibule with glass walls and sliding doors as a staffroom. Patients were instructed to arrive within a 15-minute time window at which time they would drive through the lane and stop their cars under an awning over the driveway. Ophthalmic technicians wearing appropriate personal protective equipment then approached each car, confirmed patient information, and measured IOP. Once the data were recorded using a mobile workstation, the physician was able to complete each visit by discussing the findings and therapeutic plan with the patient, either in-person in real time or virtually by phone or video visit at a later time.

Results:
A total of 241 visits were completed over 14 half day clinic sessions, with number of drive-through visits ranging from 5 to 45 per session.

Conclusions:
It is possible to institute a drive-through model of IOP checks for glaucoma patients which is efficient and minimizes the risk of exposure to COVID-19 for patients and staff.
Ocular findings in metabolic syndrome: a review
Authors: Lima-Fontes Mário , Barata Pedro , Falcão Manuel , Carneiro Ângela 
Published: December 2020

AbstractMetabolic syndrome (MetS) has emerged as a worldwide health hazard of the modern lifestyle, representing a cluster of metabolic abnormalities and a risk factor for cardiovascular disease. Eye diseases, such as diabetic retinopathy, central retinal artery occlusion, cataract, age-related macular degeneration, glaucoma, and dry eye syndrome have been linked with many of MetS components. Their relationship with MetS itself is, however, a recent topic of investigation. This review aims to gather published evidence supporting associations between ocular findings and MetS and to explore the related physiopathological processes that congregate in this syndrome and lead to these diseases. Despite compiling interesting and compelling evidence, it raises awareness to the need of further studies in this field to keep solidifying these associations and unveiling the pathological processes that support them. It ultimately targets MetS patients as a population of individuals who are at increased risk of developing age-related eye diseases and vision loss.
Health-Related Quality of Life Declines Over 3 Years for Congenital Heart Disease Survivors
Authors: Jackson Jamie L. , DeSalvo Jennifer , Leslie Carine E. , Rausch Joseph R. 
Published: December 2020

Background
Because of medical advancements, many congenital heart disease (CHD) survivors are relatively symptom-free until adulthood, at which time complications may occur. Worsening health status likely drives a change in patient-reported outcomes, such as health-related quality of life (HRQoL), although change in HRQoL has not been investigated among adolescent and young adult CHD survivors.

Objective
The aims of the current mixed cross-sectional and longitudinal study were to (1) examine changes in HRQoL over 3 years and (2) identify any demographic (age, sex, estimated family income, and distance from medical center) and medical predictors (functional status and number of cardiac-related medications) of that change.

Methods
Baseline and 3-year follow-up data were obtained via an online survey of 172 CHD survivors (15–39 years old at baseline; 25% simple, 45% moderate, 30% complex) recruited from a pediatric hospital and an adult hospital. Medical predictors were abstracted from electronic medical records.

Results
After controlling for New York Heart Association functional class, mixed-effects models identified significant declines in all subscales of the Research and Development Corporation 36-Item Health Survey 1.0 across the 3-year timeframe. A lower estimated family income (≤$35 000) predicted more decline in physical functioning (b = 0.5, 95% confidence interval, 0.2–0.8; P = .001) and emotional functioning (b = 0.3, 95% confidence interval, 0.1–0.5; P = .017). No other significant demographic or medical predictors were identified.

Conclusions
Study findings highlight the importance of tracking patient-reported outcomes over time, suggesting that medical staff should discuss HRQoL with CHD survivors during late adolescence and early adulthood before decline.
Pilot Study of the Performance of 19-G Needle in Endobronchial Ultrasound-guided Transbronchial Aspiration for the Diagnosis and Testing of Molecular Markers in Lung Cancer
Authors: Wahidi Momen M. , Davidson Kevin , Shofer Scott , Mahmood Kamran , Cheng George , Giovacchini Coral , Jones Claudia , Jug Rachel , Pavlisko Elizabeth N. , Wang Xiaofei , Gu Lin , Weimholt Cody , Zhou Zhongren , Chen Alexander 
Published: December 2020

Background:
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become the standard for diagnosis and staging of lung cancer. Historically, 21- and 22-G needles have been paired with EBUS. We evaluated the performance of EBUS-TBNA using a larger 19-G needle in the assessment of tumor tissue obtained and success of testing for molecular markers.

Methods:
We prospectively enrolled adult patients with lymphadenopathy concerning for metastatic lung cancer. Patients underwent diagnostic EBUS-TBNA utilizing 19-G needles. Cases of non–small cell lung cancer (NSCLC) were evaluated for programmed cell death receptor ligand (PD-L1) expression. Cases of adenocarcinoma or undifferentiated NSCLC were further evaluated for 3 molecular markers for driver mutations: epidermal growth factor receptor (EGFR), c-ros oncogene 1 (ROS-1), and anaplastic lymphoma kinase (ALK).

Results:
Fifty patients were enrolled and underwent EBUS-TBNA using 19-G needles. PD-L1 assay was successfully performed in 90% of NSCLC cases. In adenocarcinoma or undifferentiated NSCLC cases, the success rate in testing was 90% for EGFR and 86% for ALK. ROS-1 testing had a success rate of 67%; 24% of these specimens had adequate tumor cells but there was technical difficulty with the assay. Block quality was judged by total number of tumor cells per hematoxylin and eosin–stained slide of each cell block (58% of specimens had >500 cells and 22% had 200 to 500 cells). There were no adverse events.

Conclusion:
EBUS-TBNA using 19-G needles can obtain a high number of tumor cells and has a high rate of success in performing assays for PD-L1, EGFR, and ALK in NSCLC patients without an increase in adverse events. The success rate of ROS-1 testing was lower.
Correlation Between Anatomic Variations of Sphenoid Sinuses and Pituitary Adenoma
Authors: Guo Fang , Li Zhongzhen , Tian Chao , Yan Yujia , Yao Xiuhua , Tong Xiaoguang , Yan Hua 
Published: December 2020

Background:
Many persons have studied relationship between anatomic variations (AVs) of sphenoid sinuses (SS) and paranasal disease, but no research has been done to reveal the correlation between AVs of SS and sellar region lesions.

Objective:
To compare AVs of SS between sellar region lesions and healthy persons and analyze factors affecting the volume of SS and explore the correlation between AVs of SS and pituitary adenomas (PAs).

Methods:
Clinical data of 53 PAs as experiment group and 30 healthy persons as control team was reviewed. Computed tomography images of SS performed at Tianjin Huanhu Hospital were studied. The AVs of SS including degree of pneumatization, type of intersinus septum (IS), and volume of SS were evaluated by ITK-SNAP software.

Results:
Age, gender, degree of pneumatization, and type of IS had no significant difference between groups, while the volume of SS in experiment group was smaller than that in control group (P < 0.05). The volume of SS was associated with age, sex, degree of pneumatization, type of IS in control group, and degree of pneumatization, type of IS in experiment group. In experiment group, patients with postoperative pathological examination ki67 ≥ 3% had bigger volume and higher recurrent rate (P < 0.05).

Conclusion:
Visualizing different orientations and 3D model of SS is conducive to the success of trans-sphenoid surgery. Pituitary adenomas can deform the SS leading to smaller volume. The volume of SS can be a factor used to predict the outcome of PAs.
Safe and Efficient Removal of Massive Head and Neck Vascular Malformations Using Vessel Sealing Energy Devices
Authors: Tom Alan , Powers Jeremy M. , Chaiyasate Kongkrit 
Published: December 2020

Abstract
Large vascular malformations (VMs) pose several difficult clinical challenges to the plastic surgeon. Traditionally surgical dissection was labor-intensive and required a significant amount of time and technique. The advent of more advanced vessel sealing devices has resulted in easier vascular and lymphatic control during resection surgery. The authors present 2 cases of large VMs resected using newer energy devices. First, an infant who was born with a large neck AVM that was acutely bleeding requiring immediate control. The authors utilized the Impact Ligasure device to perform a subtotal resection, stabilize the patient, and returned for definitive resection in the future. In the second case, an adult male with a large complex tongue/lip AVM, presented for elective resection. He underwent staged sclerotherapy, followed by resection using the Harmonic Scalpel. The use of vessel sealing devices allows for a safe and efficient resection for a previously difficult surgery.
Rare Cause of Blurred Vision: Unilateral Primary Dural Ectasia of the Optic Nerve Sheath
Authors: Gozgec Elif , Ogul Hayri 
Published: December 2020

Abstract
Dural ectasia, also known as meningocele of the optic nerve sheath, is a rare benign pathology. Magnetic resonance imaging has a great role in the diagnosis of this condition, which has nonspecific symptoms such as progressive blurred vision. It is observed as cerebrospinal fluid accumulation within the expanded nerve sheath around the optic nerve. Treatment is planned after differential diagnosis of other pathologies such as mass and inflammation in addition to diagnosis with magnetic resonance imaging. Medical treatment is usually sufficient, and surgical treatment is planned for progressive patients.
A Novel Application of the Modified Angoff Method to Rate Case Difficulty in Simulation-Based Research
Authors: Joseph Melissa N. , Chang Jungsoo , Buck Samuel G. , Auerbach Marc A. , Wong Ambrose H. , Beardsley Thomas D. , Reeves Philip M. , Ray Jessica M. , Evans Leigh V. 
Published: December 2020

Introduction
Simulation use in research is often limited by controlling for scenario difficulty when using repeated measures. Our study assesses the feasibility of the Modified Angoff Method to reach expert consensus regarding difficulty of medical simulations. We compared scores with participant physiologic stress.

Methods
Emergency medicine physicians with expertise in simulation education were asked to review 8 scenarios and estimate the percentage of resident physicians who would perform all critical actions using the modified Angoff method. A standard deviation (SD) of less than 10% of estimated percentage correct signified consensus. Twenty-five residents then performed the 6 scenarios that met consensus and heart rate variability (HRV) was measured.

Results
During round 1, experts rated 4/8 scenarios within a 10% SD for postgraduate year 3 (PGY3) and 3/8 for PGY4 residents. In round 2, 6/8 simulation scenarios were within an SD of 10% points for both years. Intraclass correlation coefficient was 0.84 for PGY3 ratings and 0.89 for PGY4 ratings. A mixed effects analysis of variance showed no significant difference in HRV change from rest to simulation between teams or scenarios. Modified Angoff Score was not a predictor of HRV (multiple R
2 = 0.0176).

Conclusions
Modified Angoff ratings demonstrated consensus in quantifying the estimated percentage of participants who would complete all critical actions for most scenarios. Although participant HRV did decrease during the scenarios, we were unable to significantly correlate this with ratings. This modified Angoff method is a feasible approach to evaluate simulation difficulty for educational and research purposes and may decrease the time and resources necessary for scenario piloting.
B-cell Deficiency Attenuates Transplant Glomerulopathy in a Rat Model of Chronic Active Antibody-mediated Rejection
Authors: Reese Shannon R. , Wilson Nancy A. , Huang Yabing , Ptak Lucille , Degner Kenna R. , Xiang Ding , Redfield Robert R. , Zhong Weixiong , Panzer Sarah E. 
Published: December 2020

Background.
Transplant glomerulopathy (TG) is a pathological feature of chronic active antibody-mediated rejection (cAMR) and is associated with renal allograft failure. The specific role of B cells in the pathogenesis of TG is unclear.

Methods.
We used a minor mismatched rat kidney transplant model with B cell–deficient recipients, generated by clustered regularly interspaced short palindromic repeats/Cas9 technology, to investigate the impact of B-cell depletion on the pathogenesis of TG. We hypothesized that B-cell deficiency would prevent TG in the rat kidney transplant model of cAMR. Treatment groups included syngeneic, allogeneic, sensitized allogeneic, and B cell–deficient allogeneic transplant recipients.

Results.
B cell–deficient recipients demonstrated reduced TG lesions, decreased microvascular inflammation, reduced allograft infiltrating macrophages, and reduced interferon gamma transcripts within the allograft. Allograft transcript levels of interferon gamma, monocyte chemoattractant protein-1, and interleukin-1β correlated with numbers of intragraft macrophages. B cell–deficient recipients lacked circulating donor-specific antibodies and had an increased splenic regulatory T-cell population.

Conclusions.
In this model of cAMR, B-cell depletion attenuated the development of TG with effects on T cell and innate immunity.
Mucilaginibacter glaciei sp. nov. and Mucilaginibacter pankratovii sp. nov., isolated from a glacier on the Tibetan Plateau
Authors: Yang Lei-Lei , Pang Yu , Liu Hong-Can , Xin Yu-Hua , Liu Qing 
Published: December 2020

Two Gram-stain-negative, aerobic, rod-shaped, non-motile, bacterial strains, designated as ZB1P21T and ZT4R22T, were isolated from ice and cryoconite samples collected from Zepu glacier on the Tibetan Plateau, PR China. The phylogenetic analysis of 16S rRNA gene showed that the two strains belong to the genus

Mucilaginibacter

. Strain ZB1P21T showed the highest similarity to

Mucilaginibacter rigui

WPCB133T (97.35 %), while strain ZT4R22T showed the highest similarity to

Mucilaginibacter gilvus

F01003T (99.11 %). The average nucleotide identity values between the two novel strains and their closest relatives were 79.42 and 85.72 % respectively. The two novel strains contained MK-7 as the major menaquinone, and summed feature 3 (comprising C16 : 1
ω7c and/or C16 : 1
ω6c), iso-C15:0, iso-C17 : 03-OH and C16 : 1
ω5c as the major fatty acids. The major polar lipid of the two novel strains were phosphatidylethanolamine. Based on these data, we propose two novel species, Mucilaginibacter glaciei sp. nov. (ZB1P21T=CGMCC 1.23981T=NBRC 113932T) and Mucilaginibacter pankratovii sp. nov. (ZT4R22T=CGMCC 1.23487T=NBRC 113931T).
BiTSC2: Bayesian inference of Tumor clonal Tree by joint analysis of Single-Cell SNV and CNA data
Authors: Chen Ziwei , Gong Fuzhou , Wan Lin , Ma Liang 
Published: December 2020

AbstractThe rapid development of single-cell DNA sequencing (scDNA-seq) technology has greatly enhanced the resolution of tumor cell profiling, providing an unprecedented perspective in characterizing intra-tumoral heterogeneity and understanding tumor progression and metastasis. However, prominent algorithms for constructing tumor phylogeny based on scDNA-seq data usually only take single nucleotide variations (SNVs) as markers, failing to consider the effect caused by copy number alterations (CNAs). Here, we proposeBiTSC2,Bayesianinference ofTumor clonalTree by joint analysis ofSingle-CellSNV andCNA data.BiTSC2takes raw reads from scDNA-seq as input, accounts for sequencing errors, models dropout rate and assigns single cells into subclones. By applying Markov Chain Monte Carlo (MCMC) sampling,BiTSC2can simultaneously estimate the subclonal scCNA and scSNV genotype matrices, sub-clonal assignments and tumor subclonal evolutionary tree. In comparison with existing methods on synthetic and real tumor data,BiTSC2shows high accuracy in genotype recovery and sub-clonal assignment.BiTSC2also performs robustly in dealing with scDNA-seq data with low sequencing depth and variant dropout rate.
A data harmonization pipeline to leverage external controls and boost power in GWAS
Authors: Chen Danfeng , Tashman Katherine , Palmer Duncan S. , Neale Benjamin , Roeder Kathryn , Bloemendal Alex , Churchhouse Claire , Ke Zheng Tracy 
Published: December 2020

AbstractThe use of external controls in genome-wide association study (GWAS) can significantly increase the size and diversity of the control sample, enabling high-resolution ancestry matching and enhancing the power to detect association signals. However, the aggregation of controls from multiple sources is challenging due to batch effects, difficulty in identifying genotyping errors, and the use of different genotyping platforms. These obstacles have impeded the use of external controls in GWAS and can lead to spurious results if not carefully addressed. We propose a unified data harmonization pipeline that includes an iterative approach to quality control (QC) and imputation, implemented before and after merging cohorts and arrays. We apply this harmonization pipeline to aggregate 27,517 European control samples from 16 collections within dbGaP. We leverage these harmonized controls to conduct a GWAS of Crohn’s disease. We demonstrate a boost in power over using the cohort samples alone, and that our procedure results in summary statistics free of any significant batch effects. This harmonization pipeline for aggregating genotype data from multiple sources can also serve other applications where individual level genotypes, rather than summary statistics, are required.