bluuebunny/crossref_metadata_2025_split huggingface dataset:
PrabotulinumtoxinA for the Treatment of Moderate-to-Severe Glabellar Lines in Adult Patients With Skin of Color: Post Hoc Analyses of the US Phase III Clinical Study Data
Authors: Taylor Susan C. , Grimes Pearl E. , Joseph John H. , Jonker Anneke , Avelar Rui L. 
Published: November 2020

BACKGROUND
Limited US clinical data are available on the use of aesthetic products in patients with skin of color (SOC).

OBJECTIVE
To compare the efficacy and safety of prabotulinumtoxinA for the treatment of glabellar lines in patients with and without SOC.

METHODS AND MATERIALS
Post hoc analyses were performed on the pooled population of all 492 patients treated with 20U prabotulinumtoxinA in the 2 US single-dose Phase III glabellar line clinical studies. Patients were grouped by Fitzpatrick skin Type: IV + V + VI (with SOC) versus I + II + III (without SOC). The primary efficacy end point was the proportion of responders with a ≥1-point improvement from baseline at maximum frown on the 4-point Glabellar Line Scale. Adverse events (AEs) were also summarized.

RESULTS
Responder rates among patients with SOC (n = 140) were lower than those without SOC (n = 352), by 5.9% on average across all visits; at no time point were differences statistically significant. At Day 30, responder rates were 94.0% and 96.0%, respectively (p = .401). Headache was the most common treatment-related AE, occurring in 12.1% and 8.2% of patients with and without SOC, respectively.

CONCLUSION
A single dose of 20U prabotulinumtoxinA was well tolerated and similar in effectiveness in patients with and without SOC for the treatment of glabellar lines.
Meta-analysis of Total Effect Decomposition in the Presence of Multiple Mediators
Authors: Zhu Yiwen , Centorrino Franca , Jackson John W. , Fitzmaurice Garrett M. , Valeri Linda 
Published: November 2020

Background:
Causal mediation analysis addresses mechanistic questions by decomposing and quantifying effects operating through different pathways. Because most individual studies are underpowered to detect mediating effects, we outlined a parametric approach to meta-analyzing causal mediation and interaction analyses with multiple mediators, compared it with a bootstrap-based alternative, and discussed its limitations.

Methods:
We employed fixed- and random-effects multivariate meta-analyses to integrate evidence on treatment–mediators and mediators–outcome associations across trials. We estimated path-specific effects as functions of meta-analyzed regression coefficients; we obtained standard errors using the delta method. We evaluated the performance of this approach in simulations and applied it to assess the mediating roles of positive symptoms of schizophrenia and weight gain in the treatment effect of paliperidone ER on negative symptoms across four efficacy trials.

Results:
Both simulations and the application showed that the meta-analytic approaches increased statistical power. In the application, we observed substantial mediating effects of positive symptoms (proportions mediated from fixed-effects meta-analysis:

JOURNAL/epide/04.03/00001648-202101000-00016/inline-graphic1/v/2023-09-08T094005Z/r/image-tiff

). Weight gain may have beneficial mediating effects; however, such benefit may disappear at high doses when metabolic side effects were excessive.

Conclusions:
Meta-analyzing causal mediation analysis combines evidence from multiple sources and improves power. Targeting positive symptoms may be an effective way to reduce negative symptoms that are challenging to treat. Future work should focus on extending the existing methods to allow for more flexible modeling of mediation.
PROGRESSION OF MYOPIC MACULOPATHY IN CHINESE CHILDREN WITH HIGH MYOPIA
Authors: Guo Yin , Liu Lijuan , Tang Ping , Lv Yanyun , Wu Min , Liang Xu , Zhang Lin , Jonas Jost. B. , Wang Yan 
Published: November 2020

Purpose:
To investigate the progression of myopic maculopathy and associated factors in highly myopic Chinese children.

Methods:
In this retrospective observational case series, biometric fundus features were morphometrically measured on photographs. Myopic maculopathy was defined as recommended by the Meta-analysis of Pathologic Myopia Study Group.

Results:
The study included 274 children (mean age: 11.7 ± 2.5 years; mean refractive error: −7.66 ± 1.87 diopters [D]) with a mean follow-up of 4.9 ± 1.2 years. Myopic maculopathy progression was detected in 52 eyes (18.9%; 95% confidence interval [CI]: 14.3–23.7%). In multivariable analysis, myopic maculopathy progression was associated with a decrease in refractive error (odds ratio [OR]: 0.72; 95% CI: 0.56–0.92; P < 0.001) (i.e., higher myopization) and enlargement of parapapillary gamma zone (OR: 7.68; 95% CI: 1.63–36.2; P = 0.002). Incident peripapillary diffuse choroidal atrophy, noted in 47 of 236 eyes (20.0%; 95% CI: 14.8–25.2%), was correlated with a decrease in refractive error (OR: 0.70; 95% CI: 0.54–0.92; P = 0.009) (i.e., higher myopization) and greater gamma zone enlargement (OR: 8.28; 95% CI: 1.33–51.7; P = 0.02).

Conclusion:
Myopia in schoolchildren may have a considerable risk of progressing to myopic maculopathy. Enlargement of parapapillary gamma zone was a main independent risk factor.
MINIMAL GAS VITRECTOMY TECHNIQUE FOR REDUCING RISK OF RETINAL DISPLACEMENT FOLLOWING RHEGMATOGENOUS RETINAL DETACHMENT REPAIR
Authors: Muni Rajeev H. , Felfeli Tina , Figueiredo Natalia , Marafon Samara B. , Escaf Luis C. , Juncal Verena R. 
Published: November 2020

Purpose:
To present a novel technique, minimal gas vitrectomy, as a means of potentially minimizing retinal displacement compared with standard vitrectomy for select cases.

Methods:
A patient with a macula off retinal detachment and break at 12 o'clock underwent a 23-gauge pars plana vitrectomy, endodiathermy of the superior break in detached retina and endolaser of the inferior break in attached retina, without air–fluid exchange. Suturing of sclerotomies, anterior chamber paracentesis of 0.3 mL followed by intravitreal injection of 0.6 mL pure SF6 was then performed. Positioning was face down for 6 hours and then steamroll up with laser retinopexy to the superior break the following day.

Results:
Postoperative fundus autofluorescence imaging demonstrated no retinal displacement.

Conclusion:
The minimal gas vitrectomy technique has the potential to minimize retinal displacement by using a smaller gas tamponade compared to standard vitrectomy in certain cases with specific postoperative positioning instructions.
REVERSIBLE BILATERAL SUBFOVEAL ELLIPSOID ZONE FOCAL THICKENING ASSOCIATED WITH OVERDOSE OF PHOSPHODIESTERASE TYPE 5 INHIBITORS INTAKE
Authors: Elizalde Javier , Laiseca Andrea , García de Oteyza Gonzalo 
Published: November 2020

Purpose:
To describe the clinical findings and outcome of an unusual case of subfoveal yellowish deposits associated with excessive doses of phosphodiesterase Type 5 inhibitors intake.

Methods:
Single retrospective case report.

Results:
A 50-year-old South American man with a personal history of multiple orally administered phosphodiesterase Type 5 inhibitors drugs to treat a chronic erectile dysfunction complained of dyschromatopsia, photophobia, and a 3-month history of blurred vision. The fundus examination revealed a symmetrical yellowish lesion in both eyes with a subfoveal hyperreflective signal on the spectral domain optical coherence tomography at the level of the ellipsoid zone. Dysregulation of the blue–yellow axis was noticed in the color vision test and the electroretinogram demonstrated a tiny decrease in the b-wave amplitude. The use of phosphodiesterase Type 5 inhibitors was discontinued and the patient was examined 3 months later. Optical coherence tomography revealed complete disappearance of the deposit in both eyes and the associated symptoms resolved rapidly with discontinuation of the drug.

Conclusion:
A bilateral ellipsoid zone subfoveal focal thickening may be related to a yellowish symmetrical spot on the fovea in patients with a history of phosphodiesterase Type 5 inhibitors overdose intake. Functional and structural findings are reversible in a short-term period after discontinuing the oral treatment.
A CASE OF MIGRATING AND RESOLVING SUBRETINAL PERFLUOROCARBON LIQUID FOLLOWING RETINAL DETACHMENT SURGERY
Authors: de Vries Ewout W , de Hoog Joeri 
Published: November 2020

Purpose:
To demonstrate unique behavior of subretinal perfluorocarbon liquid (PFCL) following macular reattachment surgery.

Methods:
An observational case report. Changes in visual functioning and consecutive optical coherence tomograms are described.

Results:
Following macular reattachment surgery with the aid of PFCL, a small residual PFCL bubble, measuring 175 μm in diameter, is noted beneath the fovea on optical coherence tomogram. During nine months of follow-up, the bubble is shown to elongate and migrate toward the vitreous space. Once the bubble reaches the inner retinal surface, it gradually becomes smaller and disappears completely. We observed anatomical restoration of the retinal layers, and maintenance of fair visual acuity (20/32 feet) without scotoma.

Conclusion:
This report shows the potential of PFCL to migrate through the retina toward the vitreous. Rather than opt for a second surgery to remove small PFCL bubbles, observation may be clinically appropriate in selected cases.
LONGITUDINAL SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF EXTRAFOVEAL POLYPS AFTER COMBINATION THERAPY
Authors: Gupta Charu , Shroff Daraius , Gupta Priyanka , Atri Neelam , Bhatia Gagan , Shroff Cyrus M. 
Published: November 2020

Purpose:
To study the efficacy of swept source optical coherence tomography angiography (SSOCTA) to longitudinally follow-up patients with extrafoveal polyps post-laser photocoagulation and anti–vascular endothelial growth factor injection.

Methods:
Observational case series. Four patients diagnosed as polypoidal choroidal vasculopathy with extrafoveal polyps on multimodal imaging were followed up serially on SSOCT, en face and cross-sectional SSOCTA at a month and then 3 monthly for a year. Indocyanine green angiography was repeated at 4 months and 1 year.

Results:
Anatomical regression of extrafoveal polyps was documented on a combination of en face and cross-sectional SSOCTA, 3 months post-laser photocoagulation and anti–vascular endothelial growth factor. Regression of polyps was maintained at the 12-month follow-up visit in all cases. Changes in branching vascular network morphology post-treatment were well-delineated on en face SSOCTA. Swept source optical coherence tomography angiography findings correlated well with the gold standard indocyanine green angiography.

Conclusion:
Swept source optical coherence tomography angiography is an effective noninvasive imaging modality to diagnose and longitudinally follow-up extrafoveal polyps postintervention. Laser photocoagulation with anti–vascular endothelial growth factor achieved regression of polyps in all cases and this was maintained over 12 months.
Impact on binocular visual function of small-incision lenticule extraction for high myopia
Authors: Gyldenkerne Anders , Ivarsen Anders , Nisted Ivan , Hjortdal Jesper 
Published: November 2020

Purpose:
To assess whether small-incision lenticule extraction (SMILE) for high myopia reduces the binocular visual function assessed by stereoacuity, binocular visual acuity, binocular contrast sensitivity, and binocular summation.

Setting:
University hospital.

Design:
Prospective case series.

Methods:
Patients with a myopic spherical equivalent of at least 6.00 diopters (D) scheduled for SMILE aimed at emmetropia were included. Psychophysical testing was performed with correction preoperatively but no correction postoperatively. Stereoacuity was assessed with the Randot Circles test and the near Frisby test, visual acuity (monocular and binocular) was assessed with high-contrast Early Treatment Diabetic Retinopathy Study charts, and contrast sensitivity (monocular and binocular) was assessed with the Pelli-Robson chart and the Freiburg Acuity and Contrast Test. Binocular summation was calculated by comparing the binocular score against the best monocular score.

Results:
A total of 138 eyes of 69 patients were included. The mean spherical equivalent changed from −7.46 D ± 1.06 (SD) to −0.23 D ± 0.40 postoperatively. Stereoacuity did not change significantly postoperatively; median change (interquartile range) was −0.32 (−6.21 to 1.55) seconds of arc with the Frisby test and 0.00 (−7.5 to 5.0) seconds of arc with the Randot test (P ≥ .06). Binocular postoperative uncorrected distance visual acuity was not different from the preoperative corrected distance visual acuity (P = .40). Contrast sensitivity declined slightly monocularly with both tests of contrast sensitivity but was unaltered binocularly (P ≥ .08). Binocular summation for visual acuity and contrast sensitivity was unaltered following surgery (P ≥ .09).

Conclusions:
SMILE for high myopia did not reduce the binocular function assessed by stereoacuity, binocular visual acuity, binocular contrast sensitivity, and binocular summation.
Distribution of angle α and angle κ in a population with cataract in Shanghai
Authors: Meng Jiaqi , Du Yu , Wei Ling , Yao Yunqian , He Wenwen , Qian Dongjin , Lu Yi , Zhu Xiangjia 
Published: November 2020

Purpose:
To describe the distribution of angle α and angle κ in a population with cataract in Shanghai.

Setting:
Eye and Ear, Nose, Throat Hospital, Fudan University, Shanghai, China.

Design:
Hospital-based, cross-sectional study.

Methods:
Angle α, angle κ, and other ocular biometric parameters were determined by IOLMaster 700. The distributions of angle α and angle κ and their associations with systemic and ocular parameters were assessed.

Results:
This study included 15 127 eyes of 15 127 cataract patients. The mean angle α and angle κ values were 0.45 ± 0.21 mm and 0.30 ± 0.18 mm, respectively. Angle α and angle κ were both predominantly located temporal to the visual axis. A greater angle α or angle κ was associated with older age, lower corneal power, shorter white-to-white distance, and shallower anterior chamber depth (all P < .05). Angle α correlated positively with angle κ. With increasing axial length (AL), angle α gradually decreased in a nonlinear way and shifted to the nasal side of the visual axis, whereas angle κ decreased in eyes with AL less than 27.5 mm but increased again in eyes with longer AL.

Conclusions:
Angle α and angle κ, both predominantly located temporal to the visual axis, were influenced by multiple anterior segment parameters. As AL increased, the changes in angle α and angle κ were nonlinear, and their locations gradually shifted from the temporal to the nasal side of the visual axis.
Comparison of rotational stability and repositioning rates of 2 presbyopia-correcting and 2 monofocal toric intraocular lenses
Authors: Lee Bryan S. , Onishi Alex C. , Chang David F. 
Published: November 2020

Purpose:
To compare the rotational stability of 2 commonly used toric presbyopia-correcting (PC) intraocular lenses (IOLs) and their monofocal toric counterparts.

Setting:
Single 2-surgeon private practice.

Design:
Retrospective study.

Methods:
This study included 2 cohorts: (1) all eyes receiving a toric ReSTOR (n = 61 eyes, 49 patients) or toric Symfony (n = 779 eyes, 520 patients) IOL from September 2016 to January 2019; and (2) all eyes receiving an AcrySof (n = 2 393) or TECNIS (n = 731) monofocal toric IOL (TIOL) from April 2015 to January 2019. Eyes were only excluded if digital marking could not be used. All patients had image-guided digital marking to verify TIOL position at the conclusion of surgery. Postoperative rotation was determined by dilated examination performed later on the day of surgery or the following morning.

Results:
The toric ReSTOR IOL was more likely to rotate 5 degrees or less than the toric Symfony IOL, 91.8% vs 79.0% (P = .01). This remained true for rotation of 10 degrees or less (100% vs 89.5%, P < 0.003). The mean rotation was 2.3 degrees for toric ReSTOR IOL compared with 4.5 for toric Symfony IOL (P = .01). Statistically significantly more eyes with toric Symfony IOL required a return to the operating room for repositioning (6.9% vs 0%, P < .03). More TECNIS monofocal TIOL eyes required surgical repositioning than AcrySof monofocal TIOL eyes (3.5% vs 1.2%, P < .001).

Conclusions:
Between these PC-TIOLs, the Symfony IOL was more likely to rotate and to require surgical repositioning than the ReSTOR IOL. The TECNIS TIOL built on the same platform as the Symfony IOL was more likely to require surgical repositioning than that by the AcrySof TIOL. Despite comparable rotational stability between the Symfony and TECNIS monofocal TIOLs, the Symfony was twice as likely to require surgical repositioning.
Keratoconus detection using OCT corneal and epithelial thickness map parameters and patterns
Authors: Yang Yuli , Pavlatos Elias , Chamberlain Winston , Huang David , Li Yan 
Published: November 2020

Purpose:
To detect keratoconus using optical coherence tomography (OCT) corneal map parameters and patterns.

Setting:
Casey Eye Institute, Oregon Health and Science University, Portland, Oregon.

Design:
Cross-sectional observational study.

Methods:
A spectral-domain OCT was used to acquire corneal and epithelial thickness maps in normal, manifest keratoconic, subclinical keratoconic, and forme fruste keratoconic (FFK) eyes. A 2-step decision tree was designed. An eye will be classified as keratoconus if both decision tree conditions are met. First, at least 1 of the 4 quantitative corneal thickness (minimum, minimum–maximum, and superonasal–inferotemporal) and epithelial thickness (standard deviation) map parameters exceed cutoff values. Second, presence of both concentric thinning pattern on the epithelial thickness map and coincident thinning patterns on corneal and epithelial thickness maps by visual inspection.

Results:
The study comprised 54 eyes from 29 normal participants, 91 manifest keratoconic eyes from 65 patients, 12 subclinical keratoconic eyes from 11 patients, and 19 FFK eyes from 19 patients. The decision tree correctly classified all normal eyes (100% specificity) and had good sensitivities for detecting manifest keratoconus (97.8%), subclinical keratoconus (100.0%), and FFK (73.7%).

Conclusions:
The 2-step decision tree provided a useful tool to detect keratoconus, including cases at early disease stages (subclinical keratoconus and FFK). OCT corneal and epithelial thickness map parameters and patterns can be used in conjunction with topography to improve keratoconus screening.
Effect of Preoperative Educational Schedule on Anxiety and Coping Mechanism Among Children and Their Parents
Authors: Yadav Madhu , Malar Kodi S , Deol Rupinder 
Published: November 2020

Introduction
Surgery is one of the main reasons for anxiety and fearful experiences of children and their parents. It is reported that up to 60% of young children experience significant preoperative anxiety. Preoperative anxiety is also common among parents, which directly leads to anxiety among children. Parental anxiety can lead to a negative impact on children's coping during new or stressful situations like children's hospitalization and going to surgery.

Material and Method
A prospective, parallel-group, randomized controlled trial was conducted on a sample of 56 children aged 7–12 years and their parents. The intervention group (n = 28) received a 15-minute virtual teaching (video) containing information about preoperative care, operation theater visit, use of common medical instruments, and postoperative care. The control group (n = 28) received standard routine care. The Hamilton Anxiety Rating Scale and Modified Observed Scale of Behavioral Distress-Revised were used to assess anxiety and coping mechanisms in both the children and their parents; nonparametric, Mann–Whitney U, and Wilcoxon signed rank tests were used for analysis.

Results
Children's level of anxiety and coping mechanisms were significantly improved in the intervention group as compared with the control group. Parents' level of anxiety and coping mechanisms were also significantly improved.

Conclusion
The Preoperative Educational Schedule virtual teaching video was effective to minimize anxiety and improve coping mechanisms among children and their parents.
Factors in Successful Humanities Integration: A Case Study of One Physical Therapist Education Program
Authors: Cammarata Jessica Lieb 
Published: November 2020

Introduction.
Humanities have been recognized as an effective pedagogical tool for developing professional behaviors and a patient-centered approach. Physical therapy education programs may aspire to add humanities to their curricula but lack knowledge of how to do it successfully. The purpose of this study was to examine methods of humanities integration and supporting factors contributing to success in one physical therapist education program.

Methods.
This research used a qualitative single case study approach. Seventeen participants from one physical therapist education program were interviewed, including faculty, students, and alumni. An onsite visit to campus also included review of artifacts and observations of campus events. Interviews were transcribed, coded, and analyzed for themes.

Results.
Four main themes emerged: learning about the human experience through real patient encounters, including narrative writing, guest speakers, and experiential learning; pedagogical approaches can increase successful use of humanities, including repeated exposure, explicitness about the benefits, and sensitivity to time constraints; strong support systems help with success of humanities integration, including culture, leadership, mentorship, and resources; and challenges remain in humanities integration, including lack of buy-in and comfort, time constraints, difficulty with assessment, and devaluing of the humanities by the profession.

Discussion.
Successful humanities integration may be cultivated by informed pedagogical approaches and attention to the institutional and departmental factors which support humanities.

Conclusion.
This study helps to guide programs looking to increase presence of humanities by providing an example of how the humanities are integrated throughout the curriculum at one physical therapist education program and the factors that have affected the success of the integration.