bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal evaluation of posterior corneal power by anterior segment optical coherence tomography 18 months following photorefractive keratectomy
Authors: Latifi Golshan , Jabbarvand Mahmoud , Davoodabadi Mahmood , Abdi Parisa , Mohammadi S.Saeed 
Published: April 2020

Purpose:
To investigate the change in anterior, posterior, and net corneal power more than 18 months after photorefractive keratectomy (PRK) by RTVue anterior segment optical coherence tomography (OCT).

Setting:
Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Design:
Prospective observational study.

Methods:
PRK was performed using Technolas TENEO 317 laser platform. Anterior, posterior, and net corneal power was measured by the RTVue-XR anterior segment OCT system with the Pachymetry + Cpwr scan pattern at baseline and months 1, 3, 6, 12, 18, and more than 18 (up to 27) after PRK.

Results:
Three hundred twenty-six eyes of 163 patients (61 men [37.4%], 102 women [62.6%]; mean age 29.71 years; range 18.5 to 46.5 years) were enrolled in this study. Mean preoperative spherical equivalent was −3.15 ± 1.50 diopter (D) (range −8.37 to −0.62 D). The mean change in net corneal power was 3.052 D, 3.281 D, 3.324 D, 3.114 D, 3.446 D, and 3.972 D at months 1, 3, 6, 12, 18, and more than 18 postoperatively compared with baseline, respectively (P < .001 for all comparisons). The mean change in posterior corneal power at postoperative visits compared with baseline was not statistically significant (P > .1) except for 1 month postoperatively, which increased by 0.13 D (P < .001). Changes in posterior corneal power were not correlated with any of the preoperative clinical and Scheimpflug variables.

Conclusions:
Posterior corneal power did not change for more than 18 months after PRK, except for an early small increase at 1 month postoperatively.
Excisional goniotomy vs trabecular microbypass stent implantation: a prospective randomized clinical trial in eyes with mild to moderate open-angle glaucoma
Authors: Falkenberry Suzanne , Singh Inder Paul , Crane Charles J. , Haider Mohammed Ali , Morgan Michael G. , Grenier Christopher P. , Brubaker Jacob W. , Balasubramani Goundappa K. , Dorairaj Syril 
Published: April 2020

Purpose:
To compare reduction in intraocular pressure (IOP) and IOP-lowering medication in eyes undergoing excisional goniotomy with Kahook Dual Blade (KDB) vs iStent microbypass implantation, both combined with phacoemulsification, in eyes with mild to moderate open-angle glaucoma (OAG).

Setting:
Nine practices in the United States.

Design:
Prospective, randomized, active-controlled, parallel-group clinical trial.

Methods:
Eyes were randomized to KDB-Phaco or iStent-Phaco group. Demographics, corrected distance visual acuity, IOP, IOP-lowering medications, and adverse events were collected at baseline and at day 1, week 1, and months 1, 3, 6, and 12 postoperatively. The primary outcome measure was the proportion of eyes at 12 months with IOP reduction of 20% or greater or IOP medication reduction of 1 or more compared with baseline.

Results:
For this study, 164 eyes of 164 patients were analyzed (82 in each group). Mean IOP was reduced at 12 months compared with baseline from 18.5 (standard of error 0.4) to 15.4 (0.4) mm Hg in the KDB-Phaco group and from 18.5 (0.3) to 16.1 (0.4) mm Hg in the iStent-Phaco group (P = .24). Mean IOP-lowering medications were reduced from 1.3 (0.1) to 0.3 (0.1) in the KDB-Phaco group and from 1.4 (0.1) to 0.4 (0.1) in the iStent-Phaco group (P = .17). Among study completers, the primary outcome was attained in 74 (93.7%) of 79 patients of KDB-Phaco eyes and 65 (83.3%) of 78 patients of iStent-Phaco eyes (P = .04). Both procedures had similar safety profiles.

Conclusions:
Both procedures lowered both IOP and the need for IOP-lowering medications effectively and safely in eyes with mild to moderate OAG and cataract. Significantly, more KDB-Phaco eyes than iStent-Phaco eyes met the primary outcome of 20% or greater IOP reduction or 1 or more medication reduction at 12 months.
Preoperative Vascular Planning of Free Flaps: Comparative Study of Computed Tomographic Angiography, Color Doppler Ultrasonography, and Hand-Held Doppler
Authors: González Martínez Jesús , Torres Pérez Asia , Gijón Vega María , Nuñez-Villaveiran Teresa 
Published: April 2020

Background:
Preoperative planning of microsurgical perforator free flaps continues to be a discussion topic among microsurgeons. The purpose of this study was to compare the ability of three methods of preoperative vascular mapping—hand-held Doppler imaging, color Doppler ultrasonography, and computed tomographic angiography—to detect perforators and their concordance with surgical findings.

Methods:
A prospective study was performed to evaluate the sensitivity, specificity, and accuracy of hand-held Doppler imaging, color Doppler ultrasonography, and computed tomographic angiography to detect free flap perforators. Each patient undergoing a free flap reconstruction was studied preoperatively with the three methods, and the results were compared to the intraoperative findings.

Results:
Fifty-three patients undergoing autologous tissue reconstruction were included. Most reconstructions (71.7 percent) were performed with anterolateral thigh flaps. The positive predictive value (color Doppler ultrasonography, 100 percent; computed tomographic angiography, 100 percent; hand-held Doppler imaging, 88.6 percent) and negative predictive value (color Doppler ultrasonography, 100 percent; computed tomographic angiography, 94.3 percent; hand-held Doppler imaging, 90.5 percent) rates were significantly different between methods. The high resolution of the color Doppler ultrasonography probe provided a direct vision of the vasculature arborization and efficiently detected vessels with diameters of less than 0.5 mm. The sensitivity, specificity, and accuracy of color Doppler ultrasonography were greater than those of both computed tomographic angiography and hand-held Doppler imaging. There was 100 percent concordance between color Doppler ultrasonography perforators and the surgical findings.

Conclusions:
Color Doppler ultrasonography provides a reproducible, harmless, and accurate way to visualize vascular anatomy. It has a high correlation with the surgical findings, signifying advantages over hand-held Doppler and computed tomographic angiography in sensitivity, specificity, and accuracy.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Diagnostic, II.
Comparison of the Pedicled Latissimus Dorsi Flap with Immediate Fat Transfer versus Abdominally Based Free Tissue Transfer for Breast Reconstruction
Authors: Black Cara K. , Zolper Elizabeth G. , Economides James M. , Abadeer Andrew , Fan Kenneth L. , Song David H. 
Published: April 2020

Background:
Abdominally based free tissue transfer (FTT) and latissimus dorsi and immediate fat transfer (LIFT) procedures are both fully autologous options for breast reconstruction. The former is specialized and requires comfort with microsurgical technique, whereas LIFT combines a common set of techniques familiar to all plastic surgeons. Comparing the two methods for clinical effectiveness and complications for equivalency in outcomes may help elucidate and enhance patient decision-making.

Methods:
A retrospective review of a prospectively maintained database between March of 2017 and July of 2018 was performed to compare the LIFTs and FTTs performed by the senior surgeon. Outcomes of interest included postoperative complications, flap success, and follow-up revision and fat-grafting procedures.

Results:
Sixty-five breasts were reconstructed by FTT; and 31 breasts were reconstructed with LIFT. Demographics were similar (p > 0.05). LIFT had a shorter length of operation time (343 ± 128 minutes versus 49 ± 137 minutes) (p < 0.0001) and a shorter length of stay (1.65 ± 0.85 days versus 3.83 ± 1.65 days) (p < 0.001). FTTs had a shorter time until drain removal (13.3 ± 4.3 days versus 24.0 ± 11.2 days) (p < 0.0001). The number of major (requiring operation) and minor complications were not statistically different (i.e., FTTs, 20.0 percent major and 27.7 percent minor; LIFT, 12.9 percent major and 19.35 percent minor) (p > 0.05). The need for revisions (FTTs, 0.80 ± 0.71; LIFT, 0.87 ± 0.71) and fat grafting (FTTs, 41.54 percent; LIFT, 58.8 percent) was not statistically different (p > 0.05).

Conclusions:
Both the LIFT and abdominally based FTT have similar outcomes and complication rates. However, LIFT may be preferred in patients who require shorter operation times. The LIFT may be the fully autologous breast reconstruction of choice for nonmicrosurgeons.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
eHealth Interventions for Solid Organ Transplant Recipients: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Tang James , James Laura , Howell Martin , Tong Allison , Wong Germaine 
Published: April 2020

Background.
Lack of support for self-management may contribute to adverse health outcomes. eHealth has the potential to support self-management, but evidence in solid organ transplantation remains unclear. This review aims to evaluate the benefits and harms of eHealth interventions to support self-management in solid organ transplant recipients.

Methods.
We searched Cochrane Central Register of Controlled Trials, MEDLINE, and Embase databases for randomized trials of eHealth interventions in solid organ transplant recipients. We calculated the risk ratios or standardized mean difference of outcomes, and summary estimates were determined using random-effects models. The Cochrane risk of bias tool and Grading of Recommendations, Assessment, Development, and Evaluations were used to assess trial quality.

Results.
Twenty-one trials from 6 countries involving 2114 participants were included. Compared with standard care, eHealth interventions improved medication adherence (risk ratio, 1.34; CI, 1.12-2.56; I2 = 75%) and self-monitoring behavior (risk ratio, 2.58; CI, 1.56-4.27; I2 = 0%) up to 12 mo posttransplant. The treatment effects were largely consistent across different subgroups except for intervention functionality and mode of delivery. The effects on other outcomes were uncertain. Nine trials reported harms. The overall risk of bias was considered high or unclear, and the quality of evidence was low to very low for all outcomes.

Conclusions.
eHealth interventions may improve medication adherence and self-monitoring behavior in the short term, but high-quality intervention studies are needed to determine whether eHealth will improve long-term patient-relevant outcomes.
Optical Coherence Tomography Findings in the Junctional Scotoma of Traquair
Authors: Harish Bindiganavile Shruthi , Bhat Nita , Adesina Ore-Ofeoluwatomi , Lee Andrew G. 
Published: April 2020

Abstract:
A 43-year-old woman presented with a right-sided visual field defect in the right eye. The visual acuity was normal and there was a right relative afferent pupillary defect. Formal visual field testing revealed a junctional scotoma of Traquair. The fundus examination showed optic atrophy in the right eye and optical coherence tomography demonstrated unilateral band atrophy. Neuroimaging revealed a sellar and suprasellar cystic pituitary adenoma for which she underwent a transsphenoidal drainage. We demonstrate the clinical and radiographic features of the junctional scotoma of Traquair and describe the differentiating features vs the junctional scotoma.
Genome-Wide Meta-Analysis Validates a Role for S1PR1 in Microtubule Targeting Agent-Induced Sensory Peripheral Neuropathy
Authors: Chua Katherina C. , Xiong Chenling , Ho Carol , Mushiroda Taisei , Jiang Chen , Mulkey Flora , Lai Dongbing , Schneider Bryan P. , Rashkin Sara R. , Witte John S. , Friedman Paula N. , Ratain Mark J. , McLeod Howard L. , Rugo Hope S. , Shulman Lawrence N. , Kubo Michiaki , Owzar Kouros , Kroetz Deanna L. 
Published: April 2020

AbstractMicrotubule targeting agents (MTAs) are anticancer therapies commonly prescribed for breast cancer and other solid tumors. Sensory peripheral neuropathy (PN) is the major dose-limiting toxicity for MTAs and can limit clinical efficacy. The current pharmacogenomic study aimed to identify genetic variations that explain patient susceptibility and drive mechanisms underlying development of MTA-induced PN. A meta-analysis of genome-wide association studies (GWAS) from two clinical cohorts treated with MTAs (CALGB 40502 and CALGB 40101) was conducted using a Cox regression model with cumulative dose to first instance of grade 2 or higher PN. Summary statistics from a GWAS of European subjects (n = 469) in CALGB 40502 that estimated cause-specific risk of PN were meta-analyzed with those from a previously published GWAS of European ancestry (n = 855) from CALGB 40101 that estimated the risk of PN. Novel single nucleotide polymorphisms in an enhancer region downstream of sphingosine-1-phosphate receptor 1 (S1PR1 encoding S1PR1; e.g., rs74497159, βCALGB40101 per allele log hazard ratio (95% CI) = 0.591 (0.254 - 0.928), βCALGB40502 per allele log hazard ratio (95% CI) = 0.693 (0.334 - 1.053); PMETA = 3.62×10−7) were the most highly ranked associations based on P-values with risk of developing grade 2 and higher PN. In silico functional analysis identified multiple regulatory elements and potential enhancer activity for S1PR1 within this genomic region. Inhibition of S1PR1 function in iPSC-derived human sensory neurons shows partial protection against paclitaxel-induced neurite damage. These pharmacogenetic findings further support ongoing clinical evaluations to target S1PR1 as a therapeutic strategy for prevention and/or treatment of MTA-induced neuropathy.
Increased travel times to United States SARS-CoV-2 testing sites: a spatial modeling study
Authors: Rader Benjamin , Astley Christina M. , Sy Karla Therese L. , Sewalk Kara , Hswen Yulin , Brownstein John S. , Kraemer Moritz U.G. 
Published: April 2020

AbstractImportanceAccess to testing is key to a successful response to the COVID-19 pandemic.ObjectiveTo determine the geographic accessibility to SARS-CoV-2 testing sites in the United States, as quantified by travel time.DesignCross-sectional analysis of SARS-CoV-2 testing sites as of April 7, 2020 in relation to travel time.SettingUnited States COVID-19 pandemic.ParticipantsThe United States, including the 48 contiguous states and the District of Columbia.ExposuresPopulation density, percent minority, percent uninsured, and median income by county from the 2018 American Community Survey demographic data.Main OutcomeSARS-CoV-2 testing sites identified in two national databases (Carbon Health and CodersAgainstCovid), geocoded by address. Median county 1 km2 gridded friction surface of travel times, as a measure of geographic accessibility to SARS-CoV-2 testing sites.Results6,236 unique SARS-CoV-2 testing sites in 3,108 United States counties were identified. Thirty percent of the U.S. population live in a county (N = 1,920) with a median travel time over 20 minutes. This was geographically heterogeneous; 86% of the Mountain division population versus 5% of the Middle Atlantic population lived in counties with median travel times over 20 min. Generalized Linear Models showed population density, percent minority, percent uninsured and median income were predictors of median travel time to testing sites. For example, higher percent uninsured was associated with longer travel time (β = 0.41 min/percent, 95% confidence interval 0.3-0.53, p = 1.2×10−12), adjusting for population density.Conclusions and RelevanceGeographic accessibility to SARS-Cov-2 testing sites is reduced in counties with lower population density and higher percent of minority and uninsured, which are also risk factors for worse healthcare access and outcomes. Geographic barriers to SARS-Cov-2 testing may exacerbate health inequalities and bias county-specific transmission estimates. Geographic accessibility should be considered when planning the location of future testing sites and interpreting epidemiological data.Key PointsSARS-CoV-2 testing sites are distributed unevenly in the US geography and population.Median county-level travel time to SARS-CoV-2 testing sites is longer in less densely populated areas, and in areas with a higher percentage of minority or uninsured populations.Improved geographic accessibility to testing sites is imperative to manage the COVID-19 pandemic in the United States.
Inferred duration of infectious period of SARS-CoV-2: rapid scoping review and analysis of available evidence for asymptomatic and symptomatic COVID-19 cases
Authors: Byrne Andrew W. , McEvoy David , B. Collins Áine , Hunt Kevin , Casey Miriam , Barber Ann , Butler Francis , Griffin John , Lane Elizabeth A. , McAloon Conor , O’Brien Kirsty , Wall Patrick , Walsh Kieran A. , More Simon J. 
Published: April 2020

AbstractObjectivesOur objective was to review the literature on the inferred duration of the infectious period of COVID-19, caused by SARS-COV-2 virus, and provide an overview of the variation depending on the methodological approach.DesignRapid scoping review. Literature review with fixed search terms, up to 1stApril 2020. Central tendency and variation of the parameter estimates for infectious period in (a) asymptomatic (b) symptomatic cases from (i) virological studies (repeated testing), (ii) tracing studies (iii)modelling studies were gathered. Narrative review of viral dynamics.Information sourcesSearch strategies developed and the following searched: PubMed, Google Scholar, MedRxiv, BioRxiv. Additionally, the Health Information Quality Authority (Ireland) viral load synthesis was utilised, which screened literature from PubMed, Embase, ScienceDirect, NHS evidence, Cochrane, medRxiv and bioRxiv, HRB open databases.ResultsThere was substantial variation in the estimates, and how infectious period was inferred. One study provided approximate median infectious period for asymptomatic cases of 6.5-9.5 days. Median pre-symptomatic infectious period across studies varied over <1-4 days. Estimated mean time from symptom onset to two negative RT-PCR tests was 13.4 days (95%CI: 10.9-15.8), but was shorter when studies included children or less severe cases. Estimated mean duration from symptom onset to hospital discharge or death (potential maximal infectious period) was 18.1 days (95%CI: 15.1–21.0); time to discharge was on average 4 days shorter than time-to-death. Viral dynamic data and model infectious parameters were often shorter than repeated diagnostic data.ConclusionsThere are limitations of inferring infectiousness from repeated diagnosis, viral loads, and viral replication data alone, and also potential patient recall bias relevant to estimating exposure and symptom onset times. Despite this, available data provides a preliminary evidence base to inform models of central tendency for key parameters, and variation for exploring parameter space and sensitivity analysis. Some current models may be underestimating infectious period.
Evaluation of “stratify and shield” as a policy option for ending the COVID-19 lockdown in the UK
Authors: McKeigue Paul M , Colhoun Helen M 
Published: April 2020

SummaryAlthough population-wide lockdowns have been successful in slowing the COVID-19 epidemic, there is a consensus among disease modellers that keeping the load on critical care services within manageable limits will require an adaptive social distancing strategy, alternating cycles of relaxation and reimposition until a vaccine is available. An alternative strategy that has been tentatively proposed is to shield the elderly and others at high risk of severe disease, while allowing immunity to build up in those at low risk until the entire population is protected. We examine the performance required from a classifier that uses information from medical records to assign risk status for a such a stratify-and-shield policy to be effective in limiting mortality when social distancing is relaxed.We show that under plausible assumptions about the level of immunity required for population-level immunity, the proportion shielded is constrained to be no more than 15% of the population. Under varying assumptions about the infection fatality ratio (from 0.1% to 0.4%) and the performance of the classifier (3 to 4.5 bits of information for discrimination), we calculate the expected number of deaths in the unshielded group. We show that with likely values of the performance of a classifier that uses information from age, sex and medical records, at least 80% of those who would die if unshielded would be allocated to the high-risk shielded group comprising 15% of the population. Although the proportion of deaths that would be prevented by effective shielding does not vary much with the infection fatality ratio, the absolute number of deaths in the unshielded varies from less than 10,000 if the infection fatality rate is 0.1% to more than 50,000 if the infection fatality rate is as high as 0.4%.For projecting the effect of an optimally applied stratify-and-shield policy, studies now under way should help to resolve key uncertainties: the extent to which infection confers immunity, the prevalence of immunity, the infection fatality ratio, and the performance of a classifier constructed using information from medical records. It is time to give serious consideration to a stratify-and-shield policy that could bring the COVID-19 epidemic to an end in a matter of months while restoring economic activity, avoiding overload of critical care services and limiting mortality.
Using Disability-Adjusted Life Years to assess the burden of road traffic injuries in Nay Pyi Taw, Myanmar
Authors: Thaw Win Ei Ei , Phanprasit Wantanee , Amnatsatsue Kwanjai , Bunnagamchairat Ariya , Bundhamcharoen Kanitta 
Published: April 2020

ABSTRACTBackgroundRoad traffic injury (RTI) is growing public health problem in Myanmar. In addition, every count in road crush is followed by remarkable burdens in the community. In this study, burden of disease (BOD) approach is used to quantify this hidden problem in the studied area.Aim/Objective/PurposeTo assess the burden of traffic injuries in Nay Pyi Taw Union Territory, MyanmarMethodsThis cross-sectional study analyzed 16,338 traffic injury victims in injury registry, from 2012 to 2016. The burden was estimated by disability-adjusted life years (DALYs). The analysis was disaggregated by sex, age and type of road users, as well as expressed the rate by per 100,000 population.Results/OutcomesIt was 60,962 DALYs in total for the studied period, with the rate of 1050.85 per 100,000 population. Although premature death in road crash was only 6.2% in the study, it attributed 87.8% of total burden. Total DALYs contributed by male were three-times higher than female. Nearly half of burden came from the young and productive population of 15-29 years. The highest DALYs rate was seen in the 20-24 years in male and 30-34 years in female. The highest RTI burden was due to motorized two-wheelers, with 69.4% of total DALYs.ConclusionThis study initiates usefulness of local data from injury registry to calculate the burden of injury. The findings highlight a huge burden of traffic injuries in the community, focusing on the hidden contribution of fatal cases and the vulnerability of young adult, male and motorcyclists in traffic accidents.