bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case Report: Tapioca Iris Melanoma: An Uncommon Presentation of an Uncommon Tumor
Authors: Monferrer-Adsuara Clara , Calvo-Andrés Ramón , Montero-Hernández Javier , Mata-Moret Lucia , Ortiz-Salvador Miguel , Cervera-Taulet Enrique 
Published: October 2020

SIGNIFICANCE
Iris tumors are rare conditions, and there is a relative paucity of recent published data on its broad clinical spectrum. Tapioca iris melanoma is a rarer yet devastating form with wide and challenging differential diagnoses because of its amelanotic nodular appearance.

PURPOSE
This study aimed to report the challenging presentation of an uncommon iris melanoma, describing the clinical and histological findings and comparing them with the existing published data.

CASE REPORT
An uncommon clinicopathological report on the tumor unusual localization, patient age, absence of elevated IOP and heterochromia, and negative S-100 stain that caused diagnostic uncertainty is presented. The patient remains free of metastatic disease 7 years after a complete tumor full-thickness excision.

CONCLUSIONS
Tapioca iris melanomas are uncommon tumors with a presentation/surgical management that differs from other malignant tumors. Ophthalmologists should consider it among the vast differential diagnoses when observing amelanotic lesions, even without the hallmark signs being evident.
Female Urethral Stricture Management: The Initial Experience of an Female Pelvic Medicine and Reconstructive Surgery-Trained Urologist
Authors: Elliott Christopher S. 
Published: October 2020

Objective
Given the rarity of female urethral strictures (the cause of <1% of female lower urinary tract symptoms), most trainees have little experience diagnosing and managing the problem as they begin practice. Presented are the female urethral stricture outcomes of an attending surgeon after the completion of a female pelvic medicine and reconstructive surgery fellowship.

Methods
With institutional review board approval, a retrospective review of all cases of suspected female urethral stricture through the first 7 years of practice was completed.

Results
Over the study period, 13 women were treated for urethral stricture. One underwent simple meatotomy, 9 underwent vaginal wall flap (Blandy) urethroplasty, and 3 underwent urethral dilation only because they were not reconstructive candidates (1 due to severe radiation damage and 2 with panurethral strictures that included the bladder neck). Women undergoing urethral dilations (n = 3) have all required subsequent dilations, whereas those undergoing reconstructive procedures have not required further intervention (all with max flow rates greater than 17 mL/s at last follow-up [median = 35 months, range = 10–70]).

Conclusion
Over the course of 7 years, our limited experience suggests that (a) urethral dilation is not usually successful but surgical reconstruction is, (b) preoperative urethral rest before reconstruction may reduce failure rates, (c) staging a stricture in the operating room is the best route to confirm the diagnosis, (d) de novo stress urinary incontinence seems to rarely if ever occur after female urethroplasty, and (e) postoperative follow-up with simple uroflow and postvoid residual testing suffices.
Atypical Ocular Coloboma in Tuberous Sclerosis-2: Report of Two Novel Cases
Authors: Bacci Giacomo M. , Polizzi Silvio , Mari Francesco , Conti Valerio , Caputo Roberto , Guerrini Renzo 
Published: October 2020

Abstract:
Tuberous sclerosis complex (TSC) is an autosomal dominant multisystemic disorder caused by mutations in either TSC1 or TSC2 genes and is characterized by hamartomas in multiple organs. The most frequent and best-known ocular manifestation in TSC is the retinal hamartoma. Less frequent ocular manifestations include punched out areas of retinal depigmentation, eyelid angiofibromas, uveal colobomas, papilledema, and sector iris depigmentation. In this article, we report 2 patients carrying known pathogenic variants in the TSC2 gene who exhibited an atypical, unilateral, iris coloboma associated with localized areas of retinal dysembryogenesis.
Enhanced Depth Imaging Optical Coherence Tomography Technology Reveals a Significant Association Between Optic Nerve Drusen Anterior Displacement and Retinal Nerve Fiber Layer Thinning Over Time
Authors: Ortiz-Toquero Sara , Muñoz-Negrete Francisco J. , Rebolleda Gema 
Published: October 2020

Background:
Optic disc drusen (ODD) are a dynamic phenomenon, and their appearance, size, and relative location may change. The purpose of this study is to evaluate and quantify the longitudinal changes of buried ODD with enhanced depth imaging (EDI) optical coherence tomography (OCT) over time.

Methods:
ODD were analyzed with Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany) and EDI technology. The peripapillary retinal nerve fiber layer (RNFL) thickness was also measured. The size and depth of ODD were compared between the baseline and study visit (at least 2 years of follow-up), and the changes were correlated with mean RNFL thickness. The repeatability, coefficient of variation, and cutoff values for size and depth on EDI-OCT were calculated.

Results:
Of 21 previously identified patients with ODD, only 12 patients (21 eyes) met the most recent diagnostic criteria according to the ODD Studies Consortium recommendations for using OCT-EDI technology. The 21 eyes were reanalyzed after a mean period of 44.7 ± 13.2 months (range: 24–71 months). Overall, 132 ODD were evaluated with a mean of 6.1 ± 2.5 ODD per eye and 1.9 ± 1.1 ODD per scan. Overall, we found a significant forward movement of the drusen between visits (P = 0.01). Most drusen (67.4%) moved anteriorly, and in approximately one-third (35.6%), this displacement exceeded the cutoff value (64.28 µm). Furthermore, we found a significant correlation between ODD shallowing and RNFL thinning during the follow-up (P ≤ 0.03; R ≥ 0.370). We did not find any significant changes in size measurements (P = 0.10) over time.

Conclusions:
In approximately one-third of buried ODD, a significant anterior movement occurred over 2 years of follow-up, and this movement was associated with significant RNFL thinning. By contrast, no significant change was detected in the size of the buried ODD.
Comparison of Peripapillary Vessel Density of Acute Nonarteritic Anterior Ischemic Optic Neuropathy and Other Optic Neuropathies With Disc Swelling Using Optical Coherence Tomography Angiography: A Pilot Study
Authors: Chuang Jasmine C. , Chan Noel C. Y. , Cheung Carol Y. , Lok Jerry K. H. , Chan Carmen K. M. 
Published: October 2020

Background:
The purpose of this study is to quantitatively compare the peripapillary vessel density (PPVD), measured with optical coherence tomography angiography (OCT-A), between acute nonarteritic anterior ischemic optic neuropathy (NAION) and other causes of disc swelling (“others”).

Methods:
In this prospective comparative case series, patients with unilateral disc swelling due to acute NAION (n = 7) and “others” (n = 7) underwent OCT-A scanning of the optic nerve head with a swept-source OCT (Triton DRI-OCT), in addition to functional assessment. OCT-A images were analyzed using an automated customized MATLAB program. Comparison was made between total and 6 sectoral PPVD (radial peripapillary capillary [RPC] and choroid layers) of affected and fellow eyes; and between the 2 groups' affected eyes. Five NAION patients had repeated assessments at 1, 3, and 6 months.

Results:
Acute NAION eyes had a significantly lower total and superonasal PPVD (both layers) compared to fellow eyes. No such difference was observed in “others” group for the RPC layer. NAION eyes also had significantly lower total RPC PPVD than affected eyes in the “others” group. Over 6 months, NAION eyes had persistently lower RPC PPVD compared to fellow eyes but the reduced choroidal PPVD resolved by 1 month.

Conclusion:
The study demonstrated reduced superonasal and total RPC PPVD in acute NAION, which persisted over 6 months. Because there is currently no single diagnostic test for NAION, use of OCT-A images to analyze RPC PPVD may potentially help distinguish acute NAION from other causes of disc swelling by quantitatively demonstrating capillary dropout in the RPC layer.
Adaptive COVID-19 Forecasting via Bayesian Optimization
Authors: Bannur Nayana , Maheshwari Harsh , Jain Sansiddh , Shetty Shreyas , Merugu Srujana , Raval Alpan 
Published: October 2020

ABSTRACTAccurate forecasts of infections for localized regions are valuable for policy making and medical capacity planning. Existing compartmental and agent-based models [1, 7–11] for epidemiological forecasting employ static parameter choices and cannot be readily contextualized, while adaptive solutions [4, 13] focus primarily on the reproduction number. In the current work, we propose a novel model-agnostic Bayesian optimization approach [3] for learning model parameters from observed data that generalizes to multiple application-specific fidelity criteria. Empirical results demonstrate the efficacy of the proposed approach with SEIR-like compartmental models on COVID-19 case forecasting tasks. A city-level forecasting system based on this approach is being used for COVID-19 response in a few highly impacted Indian cities.
COVID-19 infections following outdoor mass gatherings in low incidence areas: retrospective cohort study
Authors: Miron Oren , Yu Kun-Hsing , Wilf-Miron Rachel , Davidovitch Nadav 
Published: October 2020

AbstractObjectiveIndoor mass gatherings in counties with high COVID-19 incidence have been linked to infections. We examined if outdoor mass gatherings in counties with low COVID-19 incidence are also followed by infections.MethodsWe retrospectively examined COVID-19 incidence in 20 counties that held mass gathering rallies (19 outdoor and 1 indoor) in the United States in August-September 2020. They were compared to the rest of the United States counties. We utilized a 7-day moving average and compared the change on the gathering date and 15 days later, based on the 95% confidence interval. For control counties we used the median of the gathering dates.SettingThe United StatesPopulation8.4 million in the counties holding mass gatherings, and 324 Million in the rest of the counties in the United States.Main Outcome MeasureChange in COVID-19 incidence rate per 100,000 capita during the two weeks following mass gatherings.ResultsIn the two weeks following the gatherings, the COVID-19 incidence increased significantly in 14 of 20 counties. The county with the highest incidence increase (3.8-fold) had the 2nd lowest incidence before the gathering. The county with the highest decrease (0.4-fold) had the 3rd highest incidence before the gathering. At the gathering date, the average incidence of counties with gatherings was lower than the rest of the United States, and after the gathering, it increased 1.5-fold, while the rest of the United States increased 1.02-fold.ConclusionThese results suggest that even outdoor gatherings in areas with low COVID-19 incidence are followed by increased infections, and that further precautions should be taken at such gatherings.What is already known on the topicMass gatherings have been linked to COVID-19 infections, but it is less clear how much it happens outdoors, and in areas with low incidence.What this study addsCOVID-19 infections increased significantly in 14 of 20 counties that held mass gathering rallies in the United States, 19 of which were outdoors. The county with the highest incidence increase (3.8-fold) was outdoors and had a low incidence before the gathering. The average incidence of all 20 counties with gatherings was lower at the gathering day compared with the rest of the United State, and it increased 1.5-fold following the gatherings. Our findings suggest a need for precautions in mass gatherings, even when outdoors and in areas with a low incidence of COVID-19.
Frailty and comorbidity in predicting community COVID-19 mortality in the UK Biobank: the effect of sampling
Authors: Mak Jonathan K. L. , Kuja-Halkola Ralf , Wang Yunzhang , Hägg Sara , Jylhävä Juulia 
Published: October 2020

AbstractFrailty has been linked to increased risk of COVID-19 mortality, but evidence is mainly limited to hospitalized older individuals and analyses in community samples are scarce. This study aims to assess and compare the predictive abilities of different frailty measures – the frailty phenotype (FP), frailty index (FI), and Hospital Frailty Risk Score (HFRS), and comorbidity, measured using the Charlson Comorbidity Index (CCI), on COVID-19 mortality in a UK community sample of adults aged 52–86 years. We analyzed (i) the full sample of 428,754 UK Biobank participants and (ii) a subsample of 2,287 COVID-19 positive UK Biobank participants with data on COVID-19 outcomes between March 1 and September 21, 2020. COVID-19 positivity was confirmed by PCR, hospital records and/or death registers. Logistic regression models adjusted for age, sex, smoking, ethnicity, and socioeconomic variables with areas under the receiver operating characteristic curves (AUCs) were used in the modelling. Overall, 391 individuals died of COVID-19. In the full sample, all frailty measures and the CCI were associated with COVID-19 mortality but only the HFRS and CCI improved the predictive ability of a model including age and sex, yielding AUCs>0.80. However, when restricting analyses to the COVID-19 positive subsample, which had an over-representation of frail individuals, similar improvement in AUCs was not observed in which only the CCI was significantly associated with COVID-19 mortality. Our results suggest that HFRS and CCI can be used in COVID-19 mortality risk stratification at the population level, but they show limited added value in COVID-19 positive individuals.
Impact of Reduced Sampling Rate on Accelerometer-based Physical Activity Monitoring and Machine Learning Activity Classification
Authors: Small Scott R , Khalid Sara , Dhiman Paula , Chan Shing , Jackson Dan , Doherty Aiden R , Price Andrew J 
Published: October 2020

AbstractPurposeLowering the sampling rate of accelerometer devices can dramatically increase study monitoring periods through longer battery life, however the validity of its output is poorly documented. We therefore aimed to assess the effect of reduced sampling rate on measuring physical activity both overall and by specific behaviour types.MethodsHealthy adults wore two Axivity AX3 accelerometers on the dominant wrist and two on the hip for 24 hours. At each location one accelerometer recorded at 25 Hz and the other at 100 Hz. Overall acceleration magnitude, time in moderate-to-vigorous activity, and behavioural activities were calculated using standard methods. Correlation between acceleration magnitude and activity classifications at both sampling rates was calculated and linear regression was performed.Results54 participants wore both hip and wrist monitors, with 45 of the participants contributing >20 hours of wear time at the hip and 51 contributing >20 hours of wear time at the wrist. Strong correlation was observed between 25 Hz and 100 Hz sampling rates in overall activity measurement (r = 0.962 to 0.991), yet consistently lower overall acceleration was observed in data collected at 25 Hz (12.3% to 12.8%). Excellent agreement between sampling rates was observed in all machine learning classified activities (r = 0.850 to 0.952). Wrist-worn vector magnitude measured at 25 Hz (Acc25) can be compared to 100 Hz (Acc100) data using the transformation, Acc100 = 1.038*Acc25 + 3.310.Conclusions25 Hz and 100 Hz accelerometer data are highly correlated with predictable differences which can be accounted for in inter-study comparisons. Sampling rate should be consistently reported in physical activity studies, carefully considered in study design, and tailored to the outcome of interest.
Development of Brain Network Connectivity in Risky Drinkers During Adolescence
Authors: Baker Simon T. E. , Yücel Murat , Fornito Alex , Zalesky Andrew , Whittle Sarah , Allen Nicholas B. , Lubman Dan I. 
Published: October 2020

AbstractAlcohol consumption is common in adolescence, a time when the human brain undergoes substantial development, raising concerns about the neurodevelopmental impact of drinking alcohol, especially at high levels. Risky drinking may adversely affect the developing white matter, comprised of axonal fibre pathways that integrate anatomically distributed, and functionally specialised, neural systems. We used diffusion-weighted magnetic resonance imaging (MRI) to perform the first prospective, comprehensive and regionally unbiased connectome-wide analysis of longitudinal changes in inter-regional structural connectivity between 16.5 and 18.8 years of age, comparing adolescents who reported frequent risky drinking (n = 20) with those who reported limited risky drinking (n = 19) across this developmental period. We found no difference in the development of structural connectivity between these groups, regardless of whether inter-regional connections were quantified using streamline count, fractional anisotropy, mean diffusivity, axial diffusivity, or radial diffusivity. These findings suggest that risky drinking may have limited adverse effects on the development of inter-regional structural connectivity during mid to late adolescence.
Prediction and control of COVID-19 infection based on a hybrid intelligent model
Authors: Zhang Gengpei , Liu Xiongding 
Published: October 2020

AbstractThe coronavirus (COVID-19) is a highly infectious disease that emerged in the late December 2019 in Wuhan, China, and it has caused a worldwide outbreak, which represents a major threat to global health. It is important to design prediction research and control strategies to crush its exploding. In this study, a hybrid intelligent model is proposed to simulate the spreading dynamics of COVID-19. First, considering the control measures, such as government investment, media publicity, medical treatment and law enforcement. The infection rates are optimized by genetic algorithm (GA), then a modified susceptible-infected-quarantined-recovered (SIQR) model is proposed, then the long short-term memory (LSTM) is imbedded into the SIQR model to design the hybrid intelligent model to further optimize other parameters of the system model to obtain the optimal predictive model and control measures. This study provide a reliable model to predict cases of infection and death, and reasonable suggestion to control COVID-19.
Tracking changes in reporting of epidemiological data during the COVID-19 pandemic in Southeast Asia: an observational study during the first wave
Authors: Amit Arianna Maever L. , Pepito Veincent Christian F. , Gutierrez Bernardo , Rawson Thomas 
Published: October 2020

SummaryBackgroundWhen a new pathogen emerges, consistent case reporting is critical for public health surveillance. Tracking cases geographically and over time is key for understanding the spread of an infectious disease and how to effectively design interventions to contain and mitigate an epidemic. In this paper we describe the reporting systems on COVID-19 in Southeast Asia during the first wave in 2020, and highlight the impact of specific reporting methods.MethodsWe reviewed key epidemiological variables from various sources including a regionally comprehensive dataset, national trackers, dashboards, and case bulletins for 11 countries during the first wave of the epidemic in Southeast Asia. We recorded timelines of shifts in epidemiological reporting systems. We further described the differences in how epidemiological data are reported across countries and timepoints, and the accessibility of epidemiological data.FindingsOur findings suggest that countries in Southeast Asia generally reported precise and detailed epidemiological data during the first wave of the COVID-19 pandemic. However, changes in reporting were frequent and varied across data and countries. Changes in reporting rarely occurred for demographic data such as age and sex, while reporting shifts for geographic and temporal data were frequent. We also found that most countries provided COVID-19 individual-level data daily using HTML and PDF, necessitating scraping and extraction before data could be used in analyses.InterpretationCountries have different reporting systems and different capacities for maintaining consistent reporting of epidemiological data. As the pandemic progresses, governments may also change their priorities in data sharing. Our study thus highlights the importance of more nuanced analyses of epidemiological data of COVID-19 within and across countries because of the frequent shifts in reporting. Further, most countries provide data on a daily basis but not always in a readily usable format. As governments continue to respond to the impacts of COVID-19 on health and the economy, data sharing also needs to be prioritised given its foundational role in policymaking, and the implementation and evaluation of interventions.FundingThe work was supported through an Engineering and Physical Sciences Research Council (EPSRC) (https://epsrc.ukri.org/) Systems Biology studentship award (EP/G03706X/1) to TR. This project was also supported in part by the Oxford Martin School.The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Development and validation of multivariable machine learning algorithms to predict risk of cancer in symptomatic patients referred urgently from primary care
Authors: Savage Richard S , Messenger Mike , Neal Richard D , Ferguson Rosie , Johnston Colin , Lloyd Katherine L , Neal Matthew D , Sansom Nigel , Selby Peter , Sharma Nisha , Shinkins Bethany , Skinner Jim R , Tully Giles , Duffy Sean , Hall Geoff 
Published: October 2020

AbstractBackgroundUrgent Suspected Cancer (Two Week Wait, 2WW) referrals have improved early cancer detection but are increasingly a major burden on NHS services. This has been exacerbated by the COVID-19 pandemic.MethodWe developed and validated tests to assess the risk of any cancer for 2WW patients. The tests use routine blood measurements (FBC, U&E, LFTs, tumour markers), combining them using machine learning and statistical modelling. Algorithms were developed and validated for nine 2WW pathways using retrospective data from 371,799 referrals to Leeds Teaching Hospitals Trust (development set 224,669 referrals, validation set 147,130 referrals). A minimum set of blood measurements were required for inclusion, and missing data were modelled internally by the algorithms.ResultsWe present results for two clinical use-cases. In use-case 1, the algorithms identify 20% of patients who do not have cancer and may not need an urgent 2WW referral. In use-case 2, they identify 90% of cancer cases with a high probability of cancer that could be prioritised for review.ConclusionsCombining a panel of widely available blood markers produces effective blood tests for cancer for NHS 2WW patients. The tests are affordable, can be deployed rapidly to any NHS pathology laboratory with no additional hardware requirements.