bluuebunny/crossref_metadata_2025_split huggingface dataset:
PHACOVITRECTOMY VERSUS LENS-SPARING VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT REPAIR ACCORDING TO THE SURGICAL EXPERIENCE
Authors: Kim Min Seok , Woo Se Joon , Park Kyu Hyung 
Published: December 2020

Purpose:
To compare the efficacy and safety between lens-sparing vitrectomy and phacovitrectomy for primary rhegmatogenous retinal detachment treatment according to surgical experience.

Methods:
We retrospectively reviewed the medical records of 193 patients with primary rhegmatogenous retinal detachment who underwent either lens-sparing vitrectomy (n = 111) or phacovitrectomy (n = 82). Patients were operated by two experienced surgeons or eight vitreoretinal fellows and had a minimum follow-up of 6 months. Anatomical success rate, postoperative complications, and functional outcomes were compared.

Results:
Primary anatomical success rate was 92.8% (103/111) for lens-sparing vitrectomy and 91.5% (75/82) for phacovitrectomy (P = 0.733). The fellows had lower success rate after phacovitrectomy compared with the experts, but not statistically significant (85% [34/40] vs. 97.6% [41/42], P = 0.054). During phacovitrectomy, one zonulysis case in the experts group and four posterior capsular rupture cases in the fellows group were noted. Cystoid macular edema was found only after phacovitrectomy (12.2% [10/82]), and epiretinal membrane occurred more after phacovitrectomy than after lens-sparing vitrectomy (28% [23/82] vs. 8.1% [9/111], P < 0.001). There was no difference in the occurrence of cystoid macular edema and epiretinal membrane after phacovitrectomy between two surgeon groups (P = 0.514, 0.701, respectively).

Conclusion:
Combined phacoemulsification and vitrectomy has no additional benefit in improving the surgical outcome of primary rhegmatogenous retinal detachment management. Considering the intraoperative and postoperative complications and the relatively low success rate, phacovitrectomy may not be a desirable option in inexperienced surgeons.
MONTHLY INTRAVITREAL INFLIXIMAB IN BEHÇET'S DISEASE ACTIVE POSTERIOR UVEITIS
Authors: Refaat Mohammad , Abdullatif Abdussalam M. , Hamza Mostafa M. , Macky Tamer A. , El-Agha Mohamed-Sameh H. , Ragab Gaafar , Soliman Mahmoud M. 
Published: December 2020

Purpose:
To study the safety of extended monthly intravitreal infliximab injections in patients with active posterior uveitis in Behcet's disease.

Methods:
This is a prospective, interventional, noncomparative, open-label, pilot study of 9 monthly intravitreal infliximab injections (1 mg/0.05 mL) for 22 eyes of 16 patients with active posterior uveitis in Behcet's disease. Control of inflammation and visual outcomes were assessed, and ocular complications were monitored during the study period.

Results:
Successful treatment was achieved in 7 eyes (35%), and failure was encountered in 13 eyes (65%). Only seven eyes of six patients (35%) had completed the study and achieved complete resolution of inflammation with improved best-corrected visual acuity and no complications. Failure was either because of inability to control the inflammation in nine eyes (45%) or development of exacerbation of inflammation in four eyes (20%). Four eyes developed severe immunological reaction from the drug after first (n = 1), second (n = 2), and third (n = 1) injections and had to discontinue the injections. Kaplan–Meier survival analysis showed that the mean estimated time to failure was 3.3 ± 0.2 months, and all failed eyes required revision of their systemic immunotherapy to control the ocular inflammation.

Conclusion:
Intravitreal infliximab for active posterior uveitis in Behcet's disease was associated with a high complication rate and failure to control inflammation in most eyes. It should not be considered a substitute to systemic therapy.
BENIGN FOVEAL DEPIGMENTATION: A MULTIMODAL IMAGING INVESTIGATION
Authors: Parodi Maurizio Battaglia , Arrigo Alessandro , Bruschi Elena , Manitto Maria Pia , Martina Elisabetta , Bandello Francesco 
Published: December 2020

Purpose:
To describe the multimodal imaging characteristics of benign foveal depigmentation.

Methods:
The study was designed as prospective observational case series. Patients with benign foveal depigmentation were prospectively investigated by means of multimodal imaging, including blue-light and near-infrared fundus autofluorescence, optical coherence tomography (OCT), OCT angiography, color testing, microperimetry, and electrophysiology. The main outcome measures were vessel density and retinal pigment epithelium (RPE)/photoreceptor complex OCT reflectivity.

Results:
Overall, 4 patients were identified, with bilateral and unilateral involvement in 1 case and 3 cases, respectively. Fundus autofluorescence provided variable results, showing more impairment on near-infrared fundus autofluorescence. Structural OCT revealed slight attenuation of the outer retinal bands in the area affected by benign foveal depigmentation, associated with choroidal hypertransmission, whereas enface OCT better delineated the attenuation of the reflectivity signal. The mean reflectivity intensity of RPE/photoreceptor complex was statistically significantly reduced in patients with respect to control subjects in the benign foveal depigmentation area. Optical coherence tomography angiography, color testing, microperimetry, electrooculogram, and electroretinogram findings were normal.

Conclusion:
Benign foveal depigmentation may represent a focal RPE disease. The limited alterations within the RPE band, as visualized on enface OCT and confirmed on near-infrared fundus autofluorescence, suggest an impairment in melanin production or distribution within the RPE cells.
In the time of COVID…
Authors: Taub Leslie-Faith Morritt 
Published: December 2020

ABSTRACT
JAANP Fellow Dr. Leslie-Faith Morritt Taub, NYU Adult-Gerontology Primary Care Program Director, describes the emotional, political, and social impact of COVID-19 on one graduating cohort of nurse practitioner (NP) students at New York University and one incoming cohort of students. Through the lens of a seasoned professor she describes the changes to her teaching methods because she leads these students through the course work and clinical work required to take on the role of the NP in the midst of a global pandemic in the heart of New York City.
Measurement Properties of the Dizziness Handicap Inventory—Children and Adolescents for Children and Adolescents Postconcussion
Authors: Tiwari Devashish , Yorke Amy , Goldberg Allon , Marchetti Gregory F. , Alsalaheen Bara 
Published: December 2020

Purpose:
The purpose of this study was to examine and report the construct validity, internal consistency, and item structure of the Dizziness Handicap Inventory—Children and Adolescents (DHI-CA) in postconcussion children and adolescents.

Methods:
A retrospective chart review was conducted for 132 participants. Data were extracted on the DHI-CA, Sports Concussion Assessment Tool-III symptom inventory, and Vestibulo-ocular Motor Screening. The DHI-CA was examined for validity, internal consistency, and factor structure.

Results:
The DHI-CA had fair convergent validity (r
s = 0.30-0.40), but discriminant validity findings were inconclusive. The functional subscale demonstrated least consistent loadings and 4 items had cross-loading. Reliability analysis indicated possible item redundancy given that the overall Cronbach α was higher than the subscales.

Conclusion:
Despite demonstrating convergent validity, structural inconsistencies and possible item redundancy warrant further exploration and restructuring of the DHI-CA. Caution is recommended while making clinical decisions based on the DHI-CA results alone.

Video Abstract:
For more insights from the authors, see Supplemental Digital Content 1, available at: http://links.lww.com/PPT/A303.
Test of Infant Motor Performance for Infants in Brazil: Unidimensional Model, Item Difficulty, and Motor Function
Authors: dos Santos Chiquetti Eloá Maria , Valentini Nadia Cristina 
Published: December 2020

Background:
There is a need for appropriate tests to identify developmental delays early in life.

Objective:
This study investigates the Test of Infant Motor Performance (TIMP) unidimensional model and its ability to explain variance in items response, hierarchic order of the items, levels of difficulty, and the extent to which the items were appropriate to distinguish different levels of function for infants in Brazil.

Methods:
Six hundred fifty-five infants were assessed. Families provided sociodemographic information.

Results:
Appropriate items reliability (0.99), infit (mean = 0.99; SD = 0.46), outfit (mean = 1.34; SD = 1.58), and point-biserial correlations (−0.36 to 0.92) were obtained. The model explains 74.3% of the variance, and 76.2% of the items had adequate factor relationship.

Conclusion:
The TIMP measures a single construct, has items with different levels of difficulty, and is sensitive to detect differences in the performance of distinct groups for infants in Brazil.
Rapid Improvement Project: Improving Caregivers’ Understanding of Safety Recommendations for Neurosurgical Devices
Authors: Anokwute Miracle C. , Seibold Dianne , Jea Andrew , Ackerman Laurie L. , Raskin Jeffrey S. 
Published: December 2020

Introduction:
There has been a proliferation in the development of indwelling neuromodulatory devices with varied safety recommendations, making it difficult for providers to remain up-to-date. This deficit presents an opportunity for significant improvement in patient safety.

Methods:
We performed a search for monopolar electrocautery and magnetic resonance imaging safety recommendations for several indwelling neuromodulatory devices. We developed a questionnaire followed by an educational compendium and a posttest for 50 care providers.

Results:
Overall, there was a poor performance on the pretest (mean 39%, SD 19%) but significant improvement on the posttest (mean 71%, SD 16%), P < 0.0001. We placed the educational compendium that included all manufacturer recommendations in the operating room for easy reference. A 2.4 times decrease in the case start times of vagus nerve stimulator cases is evidence of its effectiveness.

Conclusions:
The authors highlight the lack of knowledge about manufacturer safety recommendations for indwelling neurosurgical devices, which led to the creation of operating room supplements and educational devices.
Using Quality Improvement Methodology to Standardize Doppler Acquisition in a Pediatric Cardiology Echocardiography Laboratory
Authors: Hahn Eunice , Taylor Michael , Duncan Nikki , Statile Angela , Brown James , Hill Garick , Statile Christopher 
Published: December 2020

Introduction:
In echocardiography, the Doppler principle allows the measurement of tissue velocities. Using the Bernoulli equation, velocities are translated to estimated pressure differences, which dictate the timing of cardiac interventions. Our echocardiography laboratory demonstrated variability in the Doppler interrogation of heart valves, leading to difficulties in comparison over time and study accuracy. To align with previously published quality metrics in echocardiography, our laboratory used quality improvement methodology to achieve measurable improvement in Doppler acquisition.

Methods:
We developed a standardized protocol for Doppler acquisition and translated it to a 20-point scoring system. We established a baseline over 4 months via random assessment of 2 first-time, normal studies per day. Interventions included standardizing the process for acquisition, education, visual tracking, and individual feedback.

Results:
The percentage of studies with a score of 16 or higher preintervention was 17%. The median score was 13.4. In total, we analyzed 407 studies, 173 pre- and 234 postintervention. Over a 4-month intervention period, the median score improved to 18.1, with 85% of studies achieving a score of 16 or higher. Special cause variation occurred after protocol distribution, education, and feedback.

Conclusions:
Our initiative demonstrated significant improvement in the Doppler interrogation of cardiac structures using a measurable scoring system and a concrete goal of incorporating 20 areas of Doppler assessment in normal studies. Our next step is to spread this assessment to abnormal studies, thus developing consistency in evaluating all studies throughout the laboratory.
Constructions of HIV Risk Among a Diverse Sample of HIV-Negative Young Men Who Have Sex With Men Who Are Repeat Testers
Authors: Felner Jennifer K. , Mittal Maria L. , Hoenigl Martin , Amico K. Rivet , Grelotti David J. , Eanes Alex , Hess Kristen , Crawford Jessica , Smith Laramie R. 
Published: December 2020

Introduction:
To end the HIV epidemic, HIV prevention and pre-exposure prophylaxis (PrEP) promotion efforts must reach young men who have sex with men (YMSM) at greatest risk for HIV. This study qualitatively explored whether common metrics used by clinicians, scientists, and public health officials to objectively assess HIV risk align with how YMSM conceptualize their risk for HIV and the factors that shape YMSM's risk perceptions.

Methods:
Interviews with a racially/ethnically diverse sample of HIV-negative YMSM (ages 19–24 years, 60% Latinx; n = 20) examined conceptualizations of HIV risk within the context of repeat HIV testing. Iterative, applied thematic analysis examined how participants conceptualized and constructed their HIV risk, and compared participants' descriptions of their risk with a validated quantitative assessment of HIV risk that reliably predicts HIV seroconversion in this group.

Results:
Objective quantitative assessments of HIV risk poorly aligned with participants' perceived HIV risk. Participants described their current risk in relative terms (relative to past risk and relative to friends'/peers' risk) and described age/developmental stage and changes in knowledge about HIV prevention as key factors in risk changes over time. Other factors included substance use and trust/mistrust in sexual partners and scientific advances in HIV prevention (eg, U = U and PrEP). Factors that influenced participants' perceived HIV risk were similar regardless of objective risk assessment.

Conclusions:
Quantitative assessments of risk may poorly align with risk perception among YMSM. Although objective metrics can effectively target YMSM at greatest risk for HIV transmission, interventions to improve prevention behaviors and PrEP uptake may be more effective when tailored to bridge the disconnection between objective HIV risk assessments and YMSM's constructions of risk.
Diagnostic Accuracy of Point-of-care Tests Used to Detect Arterial Disease in Diabetes
Authors: Normahani Pasha , Poushpas Sepideh , Alaa Mays , Bravis Vassiliki , Sounderajah Viknesh , Aslam Mohammed , Jaffer Usman 
Published: December 2020

Objective:
We compared the diagnostic performance of a novel point-of-care duplex ultrasound test (podiatry ankle duplex scan; PAD-scan) against commonly used bedside tests for the detection of PAD in diabetes.

Background:
PAD is a major risk factor for diabetic foot ulceration and amputation. Its diagnosis is fundamental though challenging. Although a variety of bedside tests are available, there is no agreement as to which is the most useful. PAD-scan may be advantageous over current tests as it allows for vessel visualization and more accurate arterial waveform assessment. However, its accuracy has not been previously evaluated.

Methods:
From March to October 2019, we recruited 305 patients from 2 diabetic foot clinics. The diagnostic performance of ankle-brachial pressure index, toe-brachial pressure index, transcutaneous pressure of oxygen, pulse palpation, and ankle waveform assessment using PAD-scan and Doppler devices (audible and visual waveform assessment) were assessed. The reference test was a full lower limb duplex ultrasound.

Results:
Based on the reference test, 202 (66.2%) patients had evidence of PAD. PAD-scan had a significantly higher sensitivity [95%, confidence interval (CI) 90%–97%) as compared to all other tests. Particularly low sensitivities were seen with pulse palpation (43%, CI 36%–50%) and transcutaneous pressure of oxygen (31%, CI 24%–38%). PAD-scan had a lower specificity (77%, CI 67%–84%) compared to toe-brachial pressure index (86%, CI 78%–93%; P < 0.001), but not statistically different when compared to all other tests.

Conclusions:
PAD-scan has superior diagnostic utility and is a valid first line investigation.
Simulating Retarded SEIRS model for COVID-19: will the second epidemic happen?
Authors: Mohammad Hamid Pour 
Published: December 2020

AbstractIn this paper, we want to simulate the COVID-19 epidemic according to the Retarded SEIRS model. One of the main questions in the human mind is whether the COVID-19 epidemic will happen again. Therefore, a criterion must be set for the occurrence or non-occurrence of the disease. With the Retarded SEIRS model and this criterion, we can predict whether the Covid-19 will re-emerge. So far, a large number of researches that have been presented in scientific groups or communities have been based on the SIR or SEIR model. But we assume that each recovered individual is immune to the disease for a limited time, and then will be susceptible again. As we know, this assumption was also true for SARS.
Longitudinal variability in mortality predicts Covid-19 deaths
Authors: Lundberg Jon O. , Zeberg Hugo 
Published: December 2020

AbstractWithin Europe, death rates due to covid-19 vary greatly, with some countries being hardly hit while others to date are almost unaffected. It would be of interest to pinpoint the factors that determine a country’s susceptibility to a pandemic such as covid-19.Here we present data demonstrating that mortality due to covid-19 in a given country could have been largely predicted even before the pandemic hit Europe, simply by looking at longitudinal variability of all-cause mortality rates in the years preceding the current outbreak. The variability in death rates during the influenza seasons of 2015-2019 correlate to excess mortality caused by covid-19 in 2020 (R2=0.48, p<0.0001). In contrast, we found no correlation between such excess mortality and age, population density, degree of urbanization, latitude, GNP, governmental health spendings or rates of influenza vaccinations.These data may be of some relevance when discussing the effectiveness of acute measures in order to limit the spread of the disease and ultimately deaths. They suggest that in some European countries there is an intrinsic susceptibility to fatal respiratory viral disease including covid-19; a susceptibility that was evident long before the arrival of the current pandemic.
A unified theory for the computational and mechanistic origins of grid cells
Authors: Sorscher Ben , Mel Gabriel C. , Ocko Samuel A. , Giocomo Lisa , Ganguli Surya 
Published: December 2020

AbstractThe discovery of entorhinal grid cells has generated considerable interest in how and why hexagonal firing fields might mechanistically emerge in a generic manner from neural circuits, and what their computational significance might be. Here we forge an intimate link between the computational problem of path-integration and the existence of hexagonal grids, by demonstrating that such grids arise generically in biologically plausible neural networks trained to path integrate. Moreover, we develop a unifying theory for why hexagonal grids are so ubiquitous in path-integrator circuits. Such trained networks also yield powerful mechanistic hypotheses, exhibiting realistic levels of biological variability not captured by hand-designed models. We furthermore develop methods to analyze the connectome and activity maps of our trained networks to elucidate fundamental mechanisms underlying path integration. These methods provide an instructive roadmap to go from connectomic and physiological measurements to conceptual understanding in a manner that might be generalizable to other settings.
Preventing post-surgical cardiac adhesions with a catechol-functionalized oxime hydrogel
Authors: Fujita Masaki , Policastro Gina M. , Burdick Austin , Lam Hillary T. , Ungerleider Jessica , Braden Rebecca L. , Huang Diane , Osborn Kent , Omens Jeffery H. , Madani Michael M. , Christman Karen L. 
Published: December 2020

AbstractPost-surgical cardiac adhesions represent a significant problem during routine cardiothoracic procedures. This fibrous tissue can impair heart function and inhibit surgical access in reoperation procedures. Here, we propose a novel hydrogel barrier composed of oxime crosslinked poly(ethylene glycol) (PEG) with the inclusion of a catechol (Cat) group to improve retention on the heart for pericardial adhesion prevention. This three component system is comprised of aldehyde (Ald), aminooxy (AO), and Cat functionalized PEG mixed to form the final gel (Ald-AO-Cat). Ald-AO-Cat has favorable mechanical properties, degradation kinetics, and minimal swelling, as well as superior tissue retention compared to an initial Ald-AO gel formulation. We show that the material is cytocompatible, resists cell adhesion, and led to a reduction in the severity of adhesion in anin vivorat model and a pilot porcine study. The Ald-AO-Cat hydrogel barrier may therefore serve as a promising solution for preventing post-surgical cardiac adhesions.
Humans use minimum cost movements in a whole-body task
Authors: Liu Lijia , Ballard Dana , Hayhoe Mary 
Published: December 2020

AbstractHumans have elegant bodies that allow gymnastics, piano playing, and tool use, but understanding how they do this in detail is difficult because their musculoskeletal systems are extraordinarily complicated. Nonetheless, common movements like walking and reaching can be stereotypical, and a very large number of studies have shown their movement cost a major factor. In contrast, one might think that general movements are very individuated and intractable, but a recent study has shown that in an arbitrary set of whole-body movements used to trace large-scale closed curves, near-identical posture sequences were chosen across different subjects, both in the average trajectories of the body’s limbs and in the variance within trajectories. The commonalities in that result motivate explanations for its generality. One possibility could be that humans also choose trajectories that are economical in energetic cost. To test this hypothesis, we situate the tracing data within a fifty degree of freedom dynamic model of the human skeleton that allows the computation of movement cost. Comparing the model movement cost data from nominal tracings against various perturbed tracings shows that the latter are more energetically expensive, inferring that the original traces were chosen on the basis of minimum cost.