bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poly-l-Lactic Acid for Gluteal Augmentation found to be Safe and Effective in Retrospective Clinical Review of 60 Patients
Authors: Durairaj Kalpna K. , Devgan Lara , Lee, BS Alexandria , Khachatourian, BS Nooneh , Nguyen, BS Vivian , Issa, BS Thomas , Baker Omer 
Published: September 2020

BACKGROUND
Poly-l-lactic acid (PLLA) is a well-established biostimulator that induces neocollagenesis, allowing for volume loss correction. Although PLLA is FDA approved to treat mid-to-lower facial wrinkling, it has grown increasingly popular as a nonsurgical, minimally invasive procedure for soft-tissue volume augmentation of other extremities. However, research detailing PLLA buttock injections is still lacking.

OBJECTIVE
The purpose of this study is to determine the safety and efficacy of PLLA for buttock augmentation.

MATERIALS AND METHODS
A clinical retrospective review of 60 patients (ages 23–54 years) were followed for 2 years by 2 investigators. Patients underwent 1 to 3 treatments, spaced 4 to 6 weeks apart, and received 2 to 12 vials per session (based on the patient budget). Pretreatment and post-treatment photographs were assessed by the primary and secondary investigator in blinded and double-blinded surveys, respectively. The Global Aesthetic Improvement Scale was used to quantify improvements in volume, skin texture, and cellulite dimpling.

RESULTS
Poly-l-lactic acid allows for visible volume amplification, improved skin texture, and softened cellulite dimpling in the buttocks when at least 20 vials are used.

CONCLUSION
Poly-l-lactic acid is safe and effective for overall aesthetic enhancement of the buttocks if used in adequate quantity (minimum 20 vials) for all women, independent of age or the number of sessions.
History through the eyes of a pandemic
Authors: Graversen Veronica Kon , Hamichi Sophia El , Gold Aaron , Murray Timothy G. 
Published: September 2020

Purpose of review
This review provides a historic perspective of the impact that major pandemics have had on human and their relationship with ophthalmology. The novel coronavirus epidemic is also analyzed, highlighting the relevance of the eye as a possible source of transmission, infection, and prognosis for the disease.

Results
Smallpox is suspected to be present for more than 12 000 years. However, trachoma seems to be the first recorded ophthalmological infectious disease. The deadliest pandemics include the bubonic plague, smallpox, and Spanish flu. The CoVID-19 epidemic is still developing and measures need to be implemented to prevent further escalation of the crisis.

Summary
Understanding the current facts in light of earlier historical evidence may help us prepare better to minimize the spread of infections in the future.
Conversion of Flow-restrictive Ahmed Glaucoma Valve to a Nonrestrictive Drainage Implant by Slicing the Valve Leaflets: An In Vitro Study
Authors: Senthil Sirisha , Kumar Gaddam Manoj , Sri Harsha Chittajallu Sai Naga , Choudhari Nikhil S. , Garudadri Chandrasekar , Richhariya Ashutosh 
Published: September 2020

Precis:
With a newly designed blade, slicing of the Ahmed glaucoma valve (AGV) leaflets helped to convert the flow-restrictive AGV into a non–flow-restrictive device. Flow characteristics by our in-vitro study confirmed the loss of resistance of AGV valve leaflets.

Purpose:
To describe a new blade to destroy the valve leaflets of AGV and to report the in-vitro flow characteristics of AGV after valve destruction.

Methods:
All the newly opened AGV implants and the Aurolab aqueous drainage implants (AADI, used as controls) were tested by connecting to a 27-G cannula, open manometer, digital manometer, and automated infusion pump. Data logging was done using a digital manometer at 4 Hz using computerized software. When the AGV’s flow characterization reached the steady phase, their valve functionality was destroyed by disrupting the valve leaflets, using a specially designed blade. The flow characteristics after valve slicing were compared with that of AADI.

Results:
A total of 5 FP7 AGVs and 2 AADIs were tested. After initial resistance to flow (5, 8 mm Hg) observed in the case of AADI for 1 to 3 hours, it dropped to 1 mm Hg in both the implants. The flow-restrictive AGV showed 3 distinct phases in the flow characterization. The first phase included the transient phase followed by the steady phase wherein the pressure was 11.2±2.6 (min 7, max 14) mm Hg. The pressure resistance of the AGV dropped significantly (P<0.001) to a mean of 0.4±0.54 mm Hg (1 mm Hg in 2 devices and 0 mm Hg in 3 devices) after the valve functionality was destroyed. The average time taken for this drop in pressure resistance after valve slicing was 10.2±3.0 minutes (min 7, max 15).

Conclusions:
It was possible to convert the flow-restrictive AGV into a non–flow-restrictive device by destroying the functionality of the valve leaflets. The pressure of the AGVs was similar to AADI after destroying its valve functionality.
Remote Screening for Optic Nerve Cupping Using Smartphone-based Nonmydriatic Fundus Photography
Authors: LaMonica Lauren C. , Bhardwaj Mahesh K. , Hawley Nicola L. , Naseri Take , Reupena Muagatutia S. , Cooper Michael L. , Cotran Paul R. , Roh Shiyoung , Ramsey David J. 
Published: September 2020

Précis:
Evaluation of nonmydriatic fundus photographs captured with a low-cost, smartphone-based camera facilitated remote screening of patients for enlarged optic nerve cup-to-disc ratio in the Independent Nation of Samoa, an underserved setting with one full-time ophthalmologist in the entire country.

Purpose:
To investigate factors that impact inter-rater agreement of glaucoma suspect optic disc status using a low-cost, handheld nonmydriatic fundus camera.

Methods:
Color fundus photographs were obtained using the PanOptic iExaminer attached to an iPhone 6S by a lay examiner on 206 participants in the Independent Nation of Samoa. Images were remotely graded by an ophthalmologist and optometrist, and images from participants identified as at-risk for glaucoma were escalated to a glaucoma subspecialist for review. Fundus photo brightness, contrast, and focus were measured using the cup, rim, and temporal regions of the disc. Stereoscopic image pairs were subsequently generated from a subset of individual nonmydriatic photographs.

Results:
Features suggestive of glaucoma based on optic disc cupping were identified in 16.0% (33/206) of participants. There was moderately strong agreement between graders (90.3%) with κ=0.53 [95% confidence interval (CI)=0.33-0.73]. The intraclass correlation coefficients for the cup-to-disc ratio (CDR) and its difference were 0.84 (95% CI=0.81-0.87) and 0.68 (95% CI=0.59-0.75). Of the 33 participants identified, 94% had clinical risk criteria for potential glaucoma when reviewed by a subspecialist. Color fundus photograph cup brightness was significantly associated with cup-to-disc (CDR) grade, R
2=0.36 (P<0.001), in which a brighter disc yielded a higher CDR.

Conclusions:
Smartphone-based screening is a simple, low-cost method capable of measuring the CDR of the optic nerve. When combined with testing for other glaucoma risk factors such as intraocular pressure, this method of measuring CDR may help identify those patients who should be referred for further ophthalmologic assessment. We are currently conducting studies to assess the sensitivity and specificity of smart phone-based remote screening.
Ophthalmic Artery and Superior Ophthalmic Vein Blood Flow Dynamics in Glaucoma Investigated by Phase Contrast Magnetic Resonance Imaging
Authors: Promelle Veronique , Bouzerar Roger , Daouk Joel , Iscar Claire , Milazzo Solange , Balédent Olivier 
Published: September 2020

Precis:
Ophthalmic artery (OA) and superior ophthalmic vein (SOV) blood flow were quantified by phase contrast magnetic resonance imaging (PC MRI) and seemed lower in glaucoma. Venous flow dynamics was different in glaucoma patients with a significantly decreased pulsatility.

Introduction:
Studies using color Doppler imaging and optical coherence tomography flowmetry strongly suggested that vascular changes are involved in the pathophysiology of glaucoma, but the venous outflow has been little studied beyond the episcleral veins. This study measured the OA and the SOV flow by PC MRI in glaucoma patients compared with controls.

Methods:
Eleven primary open-angle glaucoma patients, with a mean±SD visual field deficit of −2.3±2.7 dB and retinal nerve fiber layer thickness of 92±13 µ, and 10 controls of similar age, were examined by PC MRI. The mean, maximal and minimal flow over cardiac cycle were measured. The variation of flow (ΔQ) was calculated.

Results:
The OA mean±SD mean flow was 13.21±6.79 in patients and 15.09±7.62 mL/min in controls (P=0.35) and the OA maximal flow was 25.70±12.08 mL/min in patients, and 28.45±10.64 mL/min in controls (P=0.22). In the SOV the mean±SD mean flow was 6.46±5.50 mL/min in patients and 7.21±6.04 mL/min in controls (P=0.81) and the maximal flow was 9.06±6.67 in patients versus 11.96±9.29 mL/min in controls (P=0.47). The ΔQ in the SOV was significantly lower in patients (5.45±2.54 mL/min) than in controls (9.09±5.74 mL/min) (P=0.04).

Discussion:
Although no significant difference was found, the mean and maximal flow in the OA and SOV seemed lower in glaucoma patients than in controls. The SOV flow waveform might be affected in glaucoma, corroborating the hypothesis of an impairment of venous outflow in those patients.
Patients' perceptions of the pathways linking chronic pain with problematic substance use
Authors: Wyse Jessica J. , Lovejoy Jennette , Holloway Julia , Morasco Benjamin J. , Dobscha Steven K. , Hagedorn Hildi , Lovejoy Travis I. 
Published: September 2020

Abstract
Approximately one-half of patients with substance use disorders (SUDs) experience chronic pain. Yet, how patients perceive the relationship between their substance use and chronic pain remains poorly understood. We sought to identify how patients with comorbid SUD and chronic pain describe the relationship between, and mechanisms linking, these conditions. We conducted qualitative interviews with 34 patients engaged in SUD treatment who were also diagnosed with chronic pain. Interviews were transcribed verbatim and coded by both primary and secondary coders. Qualitative content analysis guided coding and analysis. Patient interviews revealed 3 primary pathways. One group of participants described SUD as developing independently from their experiences of chronic pain. A second group of participants described turning to substances to self-manage or cope with the physical and emotional aspects of chronic pain. A third group of participants described encounters with opioid medications as the causal agent initiating a SUD. Our findings build on research that has identified chronic pain and SUD as developmentally similar and mutually reinforcing, by revealing the ways in which patients themselves understand and experience the interconnections between their substance use and chronic pain.
Optimizing Recruitment Strategies and Physician Engagement for Stroke Recovery Research
Authors: Morton Allegra , Myers Moira , Whitaker Alicen A. , Kempf Katie S. , Eickmeyer Sarah M. , Abraham Michael , Rippee Michael A. , Billinger Sandra A. 
Published: September 2020

Background and Purpose:
A major challenge for stroke rehabilitation and recovery research is the recruitment and retention of participants. Our prior challenges and successes have influenced our team to rethink our approach and the potential for large-scale stroke recruitment.

Summary of Key Points:
In this special interest article, we highlight how the adoption and implementation of recruitment strategies such as physician engagement and a streamlined “customer service” approach helped us improve our enrollment and maximize efficiency. Another positive outcome of enrollment was increased representation of those who identify as underrepresented minority or live in rural areas.

Recommendations for Clinical Practice:
Rethinking our recruitment processes and infrastructure allowed for greater interprofessional interactions, minimal burden for our stroke physician team members, and maximized enrollment into our stroke studies.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A324).
Detection of COVID-19 Using Deep Learning Algorithms on Chest Radiographs
Authors: Chiu Wan Hang Keith , Vardhanabhuti Varut , Poplavskiy Dmytro , Yu Philip Leung Ho , Du Richard , Yap Alistair Yun Hee , Zhang Sailong , Fong Ambrose Ho-Tung , Chin Thomas Wing-Yan , Lee Jonan Chun Yin , Leung Siu Ting , Lo Christine Shing Yen , Lui Macy Mei-Sze , Fang Benjamin Xin Hao , Ng Ming-Yen , Kuo Michael D. 
Published: September 2020

Purpose:
To evaluate the performance of a deep learning (DL) algorithm for the detection of COVID-19 on chest radiographs (CXR).

Materials and Methods:
In this retrospective study, a DL model was trained on 112,120 CXR images with 14 labeled classifiers (ChestX-ray14) and fine-tuned using initial CXR on hospital admission of 509 patients, who had undergone COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR). The test set consisted of a CXR on presentation of 248 individuals suspected of COVID-19 pneumonia between February 16 and March 3, 2020 from 4 centers (72 RT-PCR positives and 176 RT-PCR negatives). The CXR were independently reviewed by 3 radiologists and using the DL algorithm. Diagnostic performance was compared with radiologists’ performance and was assessed by area under the receiver operating characteristics (AUC).

Results:
The median age of the subjects in the test set was 61 (interquartile range: 39 to 79) years (51% male). The DL algorithm achieved an AUC of 0.81, sensitivity of 0.85, and specificity of 0.72 in detecting COVID-19 using RT-PCR as the reference standard. On subgroup analyses, the model achieved an AUC of 0.79, sensitivity of 0.80, and specificity of 0.74 in detecting COVID-19 in patients presented with fever or respiratory systems and an AUC of 0.87, sensitivity of 0.85, and specificity of 0.81 in distinguishing COVID-19 from other forms of pneumonia. The algorithm significantly outperforms human readers (P<0.001 using DeLong test) with higher sensitivity (P=0.01 using McNemar test).

Conclusions:
A DL algorithm (COV19NET) for the detection of COVID-19 on chest radiographs can potentially be an effective tool in triaging patients, particularly in resource-stretched health-care systems.
Beauty Is in the Eye of the Beholder: Esthetic Outcome Assessment in Smile Reanimation Surgery in Patients With Facial Palsy
Authors: van Veen Martinus M. , Broekstra Dieuwke C. , Mureau Marc A.M. , Werker Paul M.N. , Dijkstra Pieter U. 
Published: September 2020

Abstract
Layperson assessments are becoming increasingly important in the evaluation of surgical procedures of the face, including smile reanimation. In this study, the authors set out to answer 3 questions: (1) are esthetic scores more dependent on the assessor or the person that is being assessed, (2) how does smile reanimation change esthetic scores, (3) do sex and age of the patient and assessor explain some of the esthetic outcomes?
Thirty-five assessors scored pre and postoperative photographs of 21 facial palsy patients undergoing smile reanimation. Linear mixed-effect models were used to investigate the effects of assessor and patient factors on esthetic outcome assessments, to examine changes after smile reanimation, and to determine whether sex and age explained part of the esthetic outcomes.
Fifty-eight percent of variation in the esthetic scores can be explained by some assessors being more positive in their esthetic scoring compared to other assessors. Twenty-nine percent was attributed to patient baseline esthetic scores. Overall esthetic scores improved after smile reanimation. Sex and age of the patient and assessor could not explain variation in the esthetic scores.
Esthetic appearance highly depends on “who is looking.” These findings are important for preoperative counseling, and for those treating and educating patients with facial palsy.
Pediatric Mandibular Central Giant Cell Granuloma: Neoadjuvant Immunotherapy to Minimize Surgical Resection
Authors: Lin Jason , Mecham Jeffrey C. , Hall S. Ryan , Oh Christine , Lettieri Salvatore 
Published: September 2020

Abstract
Central giant cell granuloma (CGCG) is a relatively uncommon benign bony lesion accounting for approximately 7% of all non-neoplastic lesions of the jaw. The clinical behavior of CGCG can vary from a slow-growing, painless lesion to fast-growing and locally destructive. When such a lesion involves the mandible, this can be quite debilitating for the patient, inhibiting oral intake and requiring an extensive resection and bone graft reconstruction. The authors present a case of effectively decreasing the surgical morbidity associated with a large and rapidly growing CGCG of the mandible in a pediatric patient. Neoadjuvant immunotherapy with denosumab (human monoclonal antibody) facilitated treatment of the tumor without the need for a large resection which would have otherwise necessitated a vascularized bony mandibular reconstruction. Consideration of neoadjuvant medical management of CGCG as the primary treatment is advocated.
A Mobile Application Patient Decision Aid for Treatment of Overactive Bladder
Authors: Khanijow Kavita D. , Leri Damien , Arya Lily A. , Andy Uduak U. 
Published: September 2020

Objective
The aim of this study was to develop and validate a mobile application patient decision aid (mPDA) for providing treatment options to women with overactive bladder (OAB).

Methods
We performed a mixed methods study. We conducted cognitive interviews to gain insight about treatment decisions for OAB. We then developed an evidence-based mPDA and conducted a prospective cohort study to validate it. Women completed the validated Decisional Conflict Scale. Construct validity was determined by comparing Decisional Conflict Scale scores before and after use of the decision aid. Concurrent validity was assessed by determining the relationship between change in Decision Conflict Scale score and a validated Patient Satisfaction Questionnaire. Discriminant validity was assessed by comparing the change in Decision Conflict Scale score in women who had failed 2 or less versus 3 or more prior treatments.

Results
Fifteen women participated in cognitive interviews. Thematic analysis revealed that women want information about adverse events, personalization of treatment options, and supplemental interactive sources. Sixty-five women participated in the validation study. Decision Conflict Scale scores improved significantly after use of the decision aid (60.2 ± 22.3 vs 18.7 ± 19.5, P < 0.001). Change in Decision Conflict Scale score correlated moderately with Patient Satisfaction Questionnaire score (r = 0.437, P = 0.003). Women with 3 or more prior treatment failures had greater improvement in Decision Conflict Scale score than women with 2 or less prior treatment failures (P < 0.001).

Conclusions
The mPDA is a valuable adjunct to physician counseling for treatment options in women with OAB.
Visual Outcomes in Leber Hereditary Optic Neuropathy Patients With the m.11778G>A (MTND4) Mitochondrial DNA Mutation
Authors: Newman Nancy J. , Carelli Valerio , Taiel Magali , Yu-Wai-Man Patrick 
Published: September 2020

Background:
Leber hereditary optic neuropathy (LHON) is a maternally inherited bilaterally blinding optic neuropathy, predominantly affecting otherwise healthy young individuals, mostly men. The visual prognosis is generally poor, with most patients worsening to at least 20/200 visual acuity. The m.11778G>A (MTND4) mitochondrial DNA mutation is the most common cause of LHON and is associated with poor outcomes and limited potential for meaningful visual recovery. Treatments for LHON are limited, and clinical trials are hampered by inadequate data regarding the natural history of visual loss and recovery. In this article, we review the current literature specifically related to visual function of LHON patients with the m.11778G>A mutation.

Evidence acquisition:
Literature review was performed using MEDLINE through PubMed, Cochrane Reviews Library, and Orpha.net with search terms of “Leber hereditary optic neuropathy,” “LHON,” “ND4,” “G11778A,” “visual acuity,” “nadir,” “natural history,” and “registry.” All English-language, peer-reviewed publications with study cohorts of at least 5 LHON patients with the molecularly confirmed m.11778G>A mutation were included.

Results:
Meta-analysis of 12 retrospective and 3 prospective studies provided visual function information on 695 LHON patients with the m.11778G>A mutation, 100 (14.4%) of whom were reported to have “recovered” some vision, although definitions of “recovery” varied among studies and idebenone use could not always be excluded. When incorporating age at onset of visual loss into the analyses, and specifically addressing those patients aged 15 years or older, meaningful visual recovery occurred in 23 of 204 (11.3%) patients. A younger age at onset, especially less than 12 years, portends a better visual prognosis and a different natural history of visual loss progression and recovery than in adults.

Conclusions:
The classic presentation of LHON patients with the m.11778G>A mutation of severe visual loss with rare or poor recovery from nadir still holds true for most affected individuals. Among patients 15 years and older, recovery of meaningful vision likely occurs in less than 20% of patients, irrespective of how recovery is defined, and ultimate visual acuities of better than 20/200 are rare. Adequate prospective studies with sufficient sample sizes of genotypically homogeneous untreated LHON patients stratified by age, immediately enrolled when symptomatic, followed regularly for adequate periods of time with consistent measures of visual function, and analyzed with a standard definition of visual improvement are unfortunately lacking. Future clinical trials for LHON will require more standardized reporting of the natural history of this disorder.
Covid-19 Cases in India: A Visual Exploratory Data Analysis Model
Authors: Jayesh S , Sreedharan Shilpa 
Published: September 2020

AbstractCovid-19 outbreak was first reported in Wuhan, China. The deadly virus spread not just the disease, but fear around the globe. On January 2020, WHO declared COVID-19 as a Public Health Emergency of International Concern (PHEIC). First case of Covid-19 in India was reported on January 30, 2020. By the time, India was prepared in fighting against the virus. India has taken various measures to tackle the situation. In this paper, an exploratory data analysis of Covid-19 cases in India is carried out. Data namely number of cases, testing done, Case Fatality ratio, Number of deaths, change in visits stringency index and measures taken by the government is used for modelling and visual exploratory data analysis.