bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validity of five formulas in estimating 24-h urinary sodium via spot urine sampling in hypertensive patients living in Northeast China
Authors: Qian Ni , Jiang Yinong , Wang Ying , Yan Peishi , Yao Fumei , Sun Min , Liu Xiaojie , Zhang Ying , Cheng Yunpeng , Lu Yan , Song Wei 
Published: December 2020

Objective:
The objective was to evaluate the accuracy of five formulas -- the Kawasaki, Tanaka, INTERSALT, Mage, and Uechi methods -- using spot urinary sampling for 24-h urinary sodium (UNa) prediction in hypertensive patients living in northeast China.

Methods:
There were 1154 hypertensive patients enrolled from multiple centers. Five different formulas were used to predict 24-h UNa excretion via spot morning urinary samples. Actual UNa excretion was measured from 24-h urine samples. The estimated value was compared with the actual value by examining biases, the intraclass correlation coefficients (ICC), and Bland–Altman plots.

Results:
The average excretion of sodium was 2.97 ± 1.26 g/day. The formula-produced mean biases for actual UNa were 0.31 g/day for INTERSALT, 0.80 g/day for Mage, 0.88 g/day for Tanaka, 1.14 g/day for Uechi, and 1.95 g/day for Kawasaki. The ICC was 0.511 for Kawasaki, 0.499 for INTERSALT, 0.468 for Tanaka, 0.402 for Mage, and 0.378 for Uechi. The least mean bias in the lower and moderate salt intake subgroups was 1.22 and 0.07 g/day, respectively, which was calculated using the Mage and INTERSALT methods. The least mean bias in the higher salt intake subgroup was 0.10 g/day for the Uechi method. The INTERSALT method was more efficiency at the individual level, with 17.4% of participants having relative differences within 10%, and 22.3% participants having absolute differences within 393 mg.

Conclusion:
The INTERSALT method may exhibit a good performance in estimating 24-h urinary sodium level for the hypertensive population living in northeast China.
Radiation Mapping for an Unmanned Aerial Vehicle: Development and Simulated Testing of Algorithms for Source Mapping and Navigation Path Generation
Authors: Liu Tairan , Di Fulvio Angela , Chung Long Kiu , Kearfott Kimberlee J. 
Published: December 2020

Abstract
Image reconstruction algorithms were developed for radiation source mapping and used for generating the search path of a moving radiation detector, such as one onboard an unmanned aerial vehicle. Simulations consisted of first assuming radioactive sources of varying complexity and estimating the radiation fields that would then be produced by that source distribution. Next, the “measurements” that would result from a pair of adjacent spatial locations were computed. A crude estimate of the source distribution likely to have produced such “measurements” was reconstructed based upon the limited measurements. Location of the next “measurement” was then determined as halfway between the location of the estimated source and the current “measurement.” With each additional sample, improved source distribution reconstructions were made and used to inform the immediate direction of detector motion. Source reconstruction or mapping was formulated as an inverse problem solved with either maximum a posteriori or least squares (LS) regression deconvolution methods. Different amounts of noise were added to the simulated “measurements,” allowing evaluation of the methods’ performances as functions of signal-to-noise ratio of the measured map. As expected, methods that promote sparsity were better suited in reconstructing point sources. Reliable prior information of the source distribution also improved the reconstruction results, especially with distributed sources. With a non-negative least square algorithm and the suggested paths it generated, location of sources was successfully estimated to an accuracy of 0.014 m within nine iterations in a single-source scenario and 12 iterations in a two-source scenario, given a 10% error on the integrated counts and a Poisson distribution of the noise associated with the measured counts.
THE LOSS OF INFRARED LIGHT SENSITIVITY OF PHOTORECEPTOR CELLS MEASURED WITH TWO-PHOTON EXCITATION AS AN INDICATOR OF DIABETIC RETINOPATHY
Authors: Łabuz Grzegorz , Rayamajhi Asu , Khoramnia Ramin , Palczewska Grażyna , Palczewski Krzysztof , Holschbach Andreas , Auffarth Gerd U. 
Published: December 2020

Purpose:
Human photoreceptors are sensitive to infrared light (IR). This sensitivity can be used as a novel indicator of retinal function. Diabetic retinopathy patients were assessed using in vivo two-photon excitation and compared their scotopic IR threshold with that of healthy patients.

Methods:
Sixty-two participants, 28 healthy and 34 with diabetic retinopathy, underwent a comprehensive eye examination, where visual acuity and contrast sensitivity were assessed. Infrared thresholds were measured in the fovea and parafovea following 30-minute dark adaptation. A two-photon excitation device was used with integrated pulsed laser light (1,045 nm) for sensitivity testing and scanning laser ophthalmoscopy for fundus imaging.

Results:
The mean Snellen visual acuity of diabetic patients (6/7.7) was worse than that of the healthy patients (6/5.5), which was significantly different (P < 0.001). Disease patients had decreased contrast sensitivity, especially at 6 and 18 cycles/degree. The mean retinal sensitivity to IR light in eyes with diabetic retinopathy (11.6 ± 2.0 dB) was significantly (P < 0.001) lower than that in normal eyes (15.5 ± 1.3 dB).

Conclusion:
Compared with healthy control subjects, the IR light sensitivity of diabetic patients was significantly impaired. Two-photon measurements can be used in the assessment of retinal disease, but further studies are needed to validate IR light stimulation in various stages of diabetic retinopathy.
FOVEA PLANA ON OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY
Authors: Chatzistergiou Vasileia , Cilliers Helena , Pournaras Jean-Antoine , Ambresin Aude 
Published: December 2020

Purpose:
To report on the reliability of optical coherence tomography angiography (OCTA) to diagnose fovea plana.

Methods:
A retrospective, cross-sectional, case–control study included patients with foveal persistence of the inner retinal layers, confirmed by spectral domain OCT, and superficial capillary plexus (SCP) and deep capillary plexus foveal vascularization confirmed by OCTA. A healthy control group was selected. The best-corrected visual acuity was obtained. Spectral-domain OCT was used for measuring the outer nuclear layer thickness, and OCTA determined the foveal avascular zone, SCP, and deep capillary plexus vascular density.

Results:
Optical coherence tomography angiography reliability, based on all parameters, reached 97%, whereas based only on SCP vascular density 91%. The plana group (n = 57) differed significantly from the control group (n = 28) in terms of foveal avascular zone, SCP, and deep capillary plexus foveal vascular density (P < 0.005). Subjects with SCP foveal vascular density >30% or foveal avascular zone <0.1 mm2 had fovea plana. The best-corrected visual acuity of the plana group had no correlation with OCTA quantitative parameters (Pearson |r|<0.18, Spearman |r|<0.44).

Conclusion:
Optical coherence tomography angiography has a high accuracy in diagnosing fovea plana, as its characteristics differ significantly from the normal population. The lack of correlation between the best-corrected visual acuity and OCTA parameters implies that reduced the best-corrected visual acuity is likely to result from coexistent diseases rather than from the foveal structure.
MISALIGNMENT BETWEEN CENTER OF FOVEAL AVASCULAR ZONE AND CENTER OF FOVEAL PHOTORECEPTORS IN EYES WITH IDIOPATHIC EPIRETINAL MEMBRANE
Authors: Hasegawa Taiji , Kawaguchi Ai , Arakawa Hisaya , Maruko Ichiro , Iida Tomohiro 
Published: December 2020

Purpose:
To determine the degree of misalignment between the center of foveal avascular zone and the center of foveal photoreceptors in eyes with an idiopathic epiretinal membrane (ERM).

Methods:
We reviewed the medical records of 61 eyes with an idiopathic ERM. A 3 × 3 mm area centered on the fovea was scanned with optical coherence tomography angiography before and at 6 months after surgery. The center of foveal avascular zone and the center of foveal photoreceptors were detected by en-face optical coherence tomography angiography images and sequential optical coherence tomography B-sections in the macular region. The presence or absence of ectopic inner foveal layers was also evaluated.

Results:
The mean distance from the center of foveal photoreceptors to the center of foveal avascular zone was 111.7 ± 106.8 µm in eyes with preoperative ERM. This distance was significantly correlated with the preoperative central foveal thickness (r = 0.33, P = 0.0104). Preoperatively, the ectopic inner foveal layers were present in 27 (44.3%) of 61 eyes. The foveal misalignment was greater in eyes with ectopic inner foveal layers than in those without ectopic inner foveal layers (158.6 ± 140.0 vs. 74.4 ± 45.4 µm, P < 0.0003). At 6 months after ERM surgery, the foveal misalignment was significantly reduced to 73.7 ± 48.0 µm (P = 0.0018).

Conclusion:
Determining the degree of misalignment between the center of foveal avascular zone and the center of foveal photoreceptors might be a useful way to evaluate the degree of ERM traction.
Lacrimal Gland Intravascular Micrometastasis From a Human Papillomavirus-Driven Anorectal Squamous Cell Carcinoma With a Review of Metastatic Disease to the Lacrimal Gland
Authors: Neerukonda Vamsee K. , Jakobiec Frederick A. , Freitag Suzanne K. , Stagner Anna M. , Wolkow Natalie 
Published: December 2020

Purpose:
To document a unique case of anorectal squamous cell carcinoma that was metastatic to the microvasculature of the lacrimal gland in a patient with human immunodeficiency virus and to review previously reported cases of metastases to the lacrimal gland.

Methods:
Both a retrospective chart review and comprehensive literature review were performed. The unusual histopathologic pattern of the current case was illustrated with immunohistochemical studies (CD31, D2-40, pancytokeratin, p16, and p63) and in situ hybridization studies for high-risk human papillomavirus types 16 and 18.

Results:
The authors describe the first case of metastatic anorectal squamous cell carcinoma to the lacrimal gland. Only 24 cases of metastatic disease to the lacrimal gland have been reported, the majority from breast carcinomas. The metastasis did not form a macroscopic lesions, instead was composed of microscopic intravascular and intraparenchymal tumor deposits, a subtle phenomena. Immunohistochemistry confirmed the presence of the intravascular neoplastic cells. p16 served as a surrogate marker for human papillomavirus-associated squamous cell carcinoma and was confirmed with in situ hybridization for human papillomavirus 16 and 18. This testing, combined with the clinical history, defined the diagnosis and confirmed human papillomavirus as the tumor driver.

Conclusions:
Metastases to the lacrimal gland remain rare, but clinicians and pathologists alike must be attuned to the possibility of subtle microscopic foci of tumor as a pattern of metastasis in scenarios without a discrete mass-forming lesion, as this may portend a poor prognosis.
Nonosseous Periocular Manifestations of Langerhans Cell Histiocytosis: A Case Report and Systematic Review
Authors: Plemel David J.A. , Benson Matthew D. , Tong C. Maya , Mahmood Muhammad N. , Pollock Travis J. 
Published: December 2020

Purpose:
Langerhans cell histiocytosis (LCH) is a disorder of dendritic cell proliferation that typically involves bone. It can be diagnostically challenging when LCH presents without bony involvement, leading to delays in diagnosis and treatment. In this study, the periocular manifestations of LCH in cases where the underlying orbital bones are not involved are described through a systematic review.

Methods:
A systematic review of the literature was performed to capture all cases of LCH that involved the periocular region but not the underlying orbital bones. These included LCH cases that involved the periocular skin, the ocular surface, and the orbital tissue. The authors also highlight an additional case where LCH presented with periocular edema and multifocal, nodular conjunctival lesions.

Result:
This review illustrates that LCH rarely presents with periocular infiltration without orbital bone involvement. In these atypical cases, LCH can present as an eyelid mass, a chalazion-like lesion, generalized periocular swelling, ocular surface lesions, or infiltration of any orbital structure. Ocular surface LCH has a higher rate of recurrence than other periocular LCH. Orbital LCH can involve any tissue including extraocular muscles, the lacrimal gland, or indistinct areas within the orbit.

Conclusions:
LCH is a clinicopathologic diagnosis. Although most cases involve the bone, any soft tissue can be involved. Biopsy is required to confirm the diagnosis of this heterogeneous disease.
Pupillary and Anterior Chamber Changes Following Upper Eyelid Blepharoplasty
Authors: Koçer Ali Mert , Sen Emine Malkoc 
Published: December 2020

Purpose:
This study investigated the preoperative and postoperative pupillary and anterior chamber (AC) characteristics of patients undergoing upper eyelid blepharoplasty.

Methods:
This prospective, cross-sectional study examined 32 eyes from 20 dermatochalasis patients. Following a detailed ophthalmological examination, quantitative pupillometry and Scheimpflug corneal topography were used to evaluate the pupil and AC characteristics of eyes on the day of operation and postoperative days 1 and 7. Static and dynamic pupillometry characteristics, including scotopic, mesopic, low photopic, and high photopic pupil diameter (PD), resting diameter, amplitude, latency, duration, and velocity of pupil contraction, and latency, duration, and velocity of pupil dilation, were measured. Additionally, AC volume, depth, and angle parameters were analyzed.

Results:
There were significant differences between scotopic, mesopic, and resting PD and the amplitude of pupil contraction. Pairwise comparisons showed that postoperative day 1 scotopic, mesopic, and resting PD and amplitude of pupil contraction measurements were significantly higher than preoperative measurements (p = 0.008, p < 0.001, p = 0.006, and p = 0.033, respectively). Additionally, scotopic and resting PD were significantly lower on postoperative day 7 compared with postoperative day 1 (p = 0.001 and p = 0.041, respectively). However, there were no significant differences in AC parameters.

Conclusions:
This study revealed that static and dynamic pupil measurements changed following blepharoplasty, with postoperative increased PD occurring particularly under low-light conditions. Therefore, low-light environments should be avoided following blepharoplasty, and patients with angle-closure risk factors should be closely monitored in the early postoperative period.
Web-Based Versus Non-Web–Based Patient Referral Patterns and Factors Affecting Them
Authors: Abdolalizadeh Parya , Kashkouli Mohsen Bahmani , Gandomi-Mohammadabadi Alireza , Karimi Nasser , Chaibakhsh Samira , Jafarpour Soheila 
Published: December 2020

Purpose:
To analyze the 8-year (2012–2019) change in the patient referral source trends to a plastic surgery practice and the factors affecting them.

Methods:
Data on demographics, referral source, and patient’s concern were recorded. The web-based referral sources were website and Instagram and non-web–based included other patients (word-of-mouth), medical professionals (physician, nurse, and optometrist), and others (printed media, TV, and radio). Patients’ concerns were divided into cosmetic and noncosmetic. The first (2012–2015) and second (2016–2019) half of the study period were also compared.

Results:
Included patients were 19,965. The 8-year referral sources, in order of frequency, were medical professionals (34%), other patients (32.7%), web-based sources (32.5%), and the others (0.7%). The web-based sources significantly increased by 2.4 times in the second half. While they had a third rank after the medical professionals and other patients in the first half of the study period, they became the first in the second half. The non-web–based source showed a decline during the study period. Type of referral sources was not significantly different between the 2 genders. A significantly higher percentage of the patients between 21 and 50 years of age were referred through web-based sources than the other age groups. Patients with cosmetic concerns were 2 times more likely to be referred through web-based sources.

Conclusion:
The web-based referral sources have significantly grown from the third rank in the beginning to the first one from 2015 till the end of study.
Accuracy of intraocular lens calculation formulas for flanged intrascleral intraocular lens fixation with double-needle technique
Authors: McMillin Jake , Wang Li , Wang Margaret Y. , Al-Mohtaseb Zaina , Khandelwal Sumitra , Weikert Mitchell , Hamill M. Bowes 
Published: December 2020

Purpose:
To evaluate the refractive prediction error (RPE) of intraocular lens (IOL) calculation formulas in eyes that have undergone the Yamane technique for scleral fixation of IOLs.

Setting:
Alkek Eye Center, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.

Design:
Retrospective case series from electronic chart review.

Methods:
Patients who had undergone scleral fixation of secondary IOLs were selected. The IOL RPEs for 4 IOL prediction formulas—Barrett Universal II, Holladay 1, Hoffer Q, and SRK/T formulas—were obtained by subtracting the predicted spherical equivalent from the postoperative spherical equivalent. The arithmetic mean RPE, mean absolute error (MAE), and percentages of eyes with prediction error of 0.50 diopter (D) or lesser and 1.00 D or lesser were calculated and compared.

Results:
Forty eyes of 40 patients met inclusion criteria. All formulas produced hyperopic mean arithmetic RPE. MAE values were 0.73 D for Holladay 1, 0.76 D for Barrett Universal II, 0.80 D for SRK/T, and 0.86 D for Hoffer Q formulas. The percentage of eyes with prediction error of 0.50 D or lesser and 1.00 D or lesser with these formulas were 45% (18 eyes) and 75% (30 eyes) for Holladay 1, 38.5% (15 eyes) and 77% (30 eyes) for Barrett Universal II, 32.5% (13 eyes) and 67.5% (27 eyes) for SRK/T, and 27.5% (11 eyes) and 62.5% (25 eyes) for Hoffer Q formulas. There were no statistically significant differences in prediction errors between the 4 formulas.

Conclusions:
Refractive outcomes of the Yamane technique were less predictable than those of standard cataract surgery. Arithmetic RPE ranged from hyperopic to predicted values for all formulas tested.
Culture-negative sepsis
Authors: Thorndike Jonathan , Kollef Marin H. 
Published: December 2020

Purpose of review
The traditional approach to sepsis treatment utilizes broad-spectrum antibiotics. Unfortunately, a significant proportion of infected patients have ‘culture-negative’ sepsis despite appropriate microbiologic assessment.

Recent findings
There has been increased interest in the past decade on the treatment of culture-negative sepsis. Outcome data comparing culture-negative sepsis with culture-positive sepsis are mixed and it is unclear if culture-negative sepsis is a distinct entity. Recent recommendations promoting antibiotic de-escalation in culture-negative sepsis can be difficult to implement. A variety of strategies have been suggested for limiting antibiotic courses among patients with negative cultures, including limiting antibiotic durations, use of antibiotic stewardship programs, early consideration of narrow antibiotics, rapid diagnostic technology, and eliminating anti-MRSA therapy based on surveillance swabs.

Summary
Owing to the difficulty inherent in studying the lack of positive data, and to the uncertainty surrounding diagnosis in patients with culture-negative sepsis, prospective data to guide antibiotic choices are lacking. However, antibiotic de-escalation in culture-negative sepsis is both recommended and feasible in patients showing clinical signs of improvement. Increased use of rapid diagnostics, careful consideration of antibiotic necessity, and antibiotic stewardship programs may result in less antibiotic days and better outcomes.
Best practice: antibiotic decision-making in ICUs
Authors: Brink Adrian John , Richards Guy 
Published: December 2020

Purpose of review
A major challenge in the ICU is optimization of antibiotic use. This review assesses current understanding of core best practices supporting and promoting astute antibiotic decision-making.

Recent findings
Limiting exposure to the shortest effective duration is the cornerstone of antibiotic decision-making. The decision to initiate antibiotics should include assessment of risk for resistance. This requires synthesis of patient-level data and environmental factors to determine whether delayed initiation could be considered in some patients with suspected sepsis until sensitivity data is available. Until improved stratification scores and clinically meaningful cut-off values to identify MDR are available and externally validated, decisions as to which empiric antibiotic is used should rely on syndromic antibiograms and institutional guidance. Optimization of initial and maintenance doses is another enabler of enhanced outcome. Stewardship practices must be streamlined by re-assessment to minimize negative effects, such as a potential increase in duration of therapy and increased risk of collateral damage from exposure to multiple, sequential antibiotics that may ensue from de-escalation.

Summary
Multiple challenges and research priorities for antibiotic optimization remain; however, the best stewardship practices should be identified and entrenched in daily practice. Reducing unnecessary exposure remains a vital strategy to limit resistance development.
Diagnostic and therapy of severe Clostridioides difficile infections in the ICU
Authors: Guery Benoit , Barbut Frédéric , Tschudin-Sutter Sarah 
Published: December 2020

Purpose of review
The purpose of the review is to provide all the recent data focusing on the diagnostic and treatment of Clostridioides difficile infection in patients admitted in the ICU.

Recent findings
In the ICU, diagnosis remains complicated with a large number of alternative diagnosis. The treatment classically relies on vancomycin but fidaxomicin and fecal microbiota transplantation are now potential solutions in selected indications.

Summary
Data on ICU-related CDI remain limited and conflicting. To date, there is no unique and simple way to obtain a diagnosis for CDI, the combination of clinical signs and a two-step testing algorithm remains the recommended gold-standard. Two molecules can be proposed for first line treatment: vancomycin and fidaxomicin. Although metronidazole may still be discussed as a treatment option for mild CDI in low-risk patients, its use for ICU-patients does not seem reasonable. Several reports suggest that fecal microbiota transplantation could be discussed, as it is well tolerated and associated with a high rate of clinical cure. CDI is a dynamic and active area of research with new diagnostic techniques, molecules, and management concepts likely changing our approach to this old disease in the near future.