bluuebunny/crossref_metadata_2025_split huggingface dataset:
CORRELATION OF PHOTORECEPTOR INTEGRITY WITH RETINAL VESSEL DENSITY AND CHORIOCAPILLARIS IN EYES WITH DIABETIC RETINOPATHY
Authors: Kim Jee Taek , Park Eun Jung 
Published: November 2021

Purpose:
To investigate the correlation of foveal photoreceptor integrity with the vessel density (VD) of the retina and choriocapillaris using swept source optical coherence tomography angiography in eyes with diabetic retinopathy.

Methods:
We retrospectively reviewed subjects having eyes with diabetic retinopathy, who underwent optical coherence tomography angiography using swept source optical coherence tomography (DRI OCT Triton; Topcon). We analyzed the area of the foveal avascular zone and VDs of the superficial capillary plexus, deep capillary plexus, and choriocapillaris. The length of the lateral extent of ellipsoid zone disruption, central subfield thickness, and subfoveal choroidal thickness were measured. Furthermore, we analyzed factors that were closely associated with the length of ellipsoid zone disruption.

Results:
A total of 159 eyes with diabetic retinopathy and 30 healthy control eyes were included in this study. In all eyes, the lengths of ellipsoid zone disruption were positively correlated with the foveal avascular zone area (P = 0.009). However, they were negatively correlated with the parafoveal VD of the superficial capillary plexus (P = 0.049), the foveal VD of deep capillary plexus (P = 0.003), and that of the choriocapillaris (P = 0.036).

Conclusion:
The size of the foveal avascular zone and ischemia at the deep capillary plexus may play an important role in maintaining foveal photoreceptor integrity in eyes with diabetic retinopathy. Considering optical coherence tomography angiography artifacts, such as projection and shadowing, future studies are required to reveal the correlation between ellipsoid zone disruption and the VD of the choriocapillaris.
Cataract surgery and intraocular lens placement in patients with Fuchs corneal dystrophy: a review of the current literature
Authors: Moshirfar Majid , Huynh Rachel , Ellis James H. 
Published: November 2021

Purpose of review
Late-onset Fuchs endothelial corneal dystrophy (FECD) is seen in approximately 4% of individuals over the age of 40. With the growing population of adults over the age of 65, ophthalmologists need to be aware of the preoperative, perioperative, and postoperative considerations involved in cataract surgery in Fuchs patients.

Recent findings
Management of cataract patients with FECD requires preoperative assessment of endothelial cell size, density, and morphology. Considerations for perioperative endothelial cell loss include patients with hyperopia and shallow anterior chambers, phacoemulsification technique, transfer of ultrasonic energy to the cornea, corneal-protective perioperative agents, as well as thermal and mechanical damage.

Summary
Ophthalmologists performing cataract surgery on patients with FECD must carefully consider the risks of endothelial cell loss during surgery and minimize the risk of corneal decompensation after surgery. Preoperative management should evaluate the severity of the FECD as well as individual factors such as cataract density, the health and thickness of the cornea, and the anterior chamber depth. Perioperative techniques, adjustments to biometry calculations, and intraocular lens (IOL) selection may help optimize visual outcomes and recovery time.
Veterans Health Administration Scheduling System: The Path to High Reliability Realization
Authors: Ford Jennifer , MacTaggart Patricia , Gunnar William 
Published: November 2021

EXECUTIVE SUMMARY
Timely access to services is the gateway to patient safety and quality, and scheduling is foundational to providing access to highly reliable care. An effective and efficient scheduling strategy is dependent on an evidence-based approach that focuses on critical drivers of the scheduling system related to patient safety and quality as well as access. As part of a continuing effort to improve access, the Veterans Health Administration (VHA) completed a direct causation analysis (2015–2020) using an evidence-based framework and comprehensive measurement plan. The analysis, described here, validates access benefits realized specialty by specialty and facility by facility, identifies opportunities for improvement, and acknowledges limitations of the change from the Veterans Information Systems and Technology Architecture scheduling system to the Medical Appointment Scheduling System.
This analysis of the assessments illustrates business validation structures, drivers, processes, and outcomes that can support leadership decision-making related to access. We drew our assessments of people, processes, policies, and technology from on-site interviews, over-the-shoulder observations, large-group discussions, and data from the VHA Support Service Center and facility data systems; we also mapped process steps, keystrokes, and workflow. Our assessments provided support for the VHA’s decision to implement the stand-alone Cerner scheduling system at one site while continuing to implement the Cerner Millennium electronic health record platform that includes the Cerner scheduling system at other VHA sites. The VHA experience provides lessons learned for healthcare leaders who seek highly reliable efforts to improve access to care.
Comparing the Effects of Traditional Education and Root-Cause Analysis on Nursing Students' Attitudes About Safety Culture and Knowledge of Safe Medication Administration Practices
Authors: Miller Kristi Sanborn 
Published: November 2021

Background:
Root-cause analysis (RCA) has been used for decades to support a culture of safety in health care institutions. Although RCA has been recommended for inclusion in a nursing curriculum, little research has been conducted on educational strategies or outcomes.

Purpose:
The study aims were to compare differences in attitudes about safety culture and knowledge of safe medication administration after education about RCA (intervention) versus traditional safe medication administration education (control) and to provide psychometric data for the Safety Attitudes Questionnaire (SAQ) with nursing students.

Methods:
An experimental pretesfy/posttest study was conducted in 3 schools of nursing (N = 117).

Results:
Although there was no significant difference in outcomes between the control and intervention groups, increases in SAQ scores were observed for the intervention group. The Cronbach's α for the SAQ was .93.

Conclusions:
The SAQ is a reliable instrument for measuring safety culture in schools of nursing.
Addressing Health Disparities in HIV: Introduction to the Special Issue
Authors: Lightfoot Marguerita , Milburn Norweeta , Loeb Stanga Lisa 
Published: November 2021

Abstract
Racial and ethnic minority, sexual and gender minority, and low-income people have historically experienced poorer health outcomes and poorer social conditions that lead to poorer health outcomes (social determinants of health) than nonminority people in the United States. To eliminate these health disparities, intentional and targeted interventions that address the needs and preferences of diverse populations are needed. To address disparities, the California HIV/AIDS Research Program focused their funding resources tightly on communities facing elevated HIV incidence or prevalence. This special issue describes interventions that aimed to increase linkage to and engagement in HIV-specific prevention or medical care, each uniquely tailored to the needs of an identified California population with disparate HIV-related health outcomes and each for implementation at a specific stage of the HIV prevention and care continuum.
We are Family: A Feasibility and Acceptability Study of an HIV Prevention Intervention With the House Ball and Gay Family Communities
Authors: Arnold Emily A. , Saberi Parya , Wong Jeffrey O. , Pollack Lance M. , Neilands Torsten B. , Benjamin Michael , Lockett Gloria , Kegeles Susan M. 
Published: November 2021

Background:
Black and Latinx sexual minority youth are disproportionately affected by HIV. The House Ball and gay family communities encompass sexual and ethnic minority youth who form chosen families that promote protective HIV-related health behaviors. We conducted a small-scale trial of the We Are Family intervention, leveraging these existing social dynamics to address HIV.

Methods:
From September 2018 to September 2019, we enrolled N = 118 for baseline and 6-month follow-up assessments. Eligible participants were 18 years or older, San Francisco Bay Area residents, members of a house or gay family or ball attendees in the past year, smartphone users, and sexually active. The intervention included one 2-hour in-person group session, community-level events, a mobile health app, and a dedicated service provider.

Results:
Ninety-seven percent of our participants were people of color, 94% were retained through follow-up. 73% attended at least 1 group session, 100% used the mobile health app, and 56% attended a community-level event. Modest changes were observed baseline to follow-up: among all participants, any condomless anal intercourse past 3 months (74.6%–66.7%, P = 0.064); among HIV-negative participants (N = 82) HIV testing past 6 months (80.7%–87.2%, P = 0.166); among HIV-positive participants (N = 34) receiving HIV primary care past 6 months (64.5%–78.8%, P = 0.139), and adherent to ART past 30 days (22.6%–28.1%, P = 0.712). 86% would be willing to refer a friend to the app, and 65% found the app to be personally relevant.

Conclusions:
We Are Family reaches and retains its target population, is feasible, acceptable, and shows promise for improving HIV-related health behavior.
Noninferiority of Monoparametric MRI Versus Multiparametric MRI for the Detection of Prostate Cancer
Authors: Raczeck Paul , Frenzel Felix , Woerner Tobias , Graeber Stefan , Bohle Rainer M. , Ziegler Gesa , Buecker Arno , Schneider Guenther K. 
Published: November 2021

Objectives
The aim of this study was to compare the diagnostic accuracy of apparent diffusion coefficient (ADC) ratios as a monoparametric magnetic resonance imaging (MRI) protocol for the detection of prostate cancer (PCa) with the established multiparametric (mp) MRI at 3.0 T.

Materials and Methods
According to power analysis, 52 male patients were included in this monocenter study with prospective data collection and retrospective, blinded multireader image analysis. The study was approved by the local ethics committee. Patients were recruited from January to December 2020. Based on mpMRI findings, patients underwent in-bore MR biopsy or prostatectomy for histopathologic correlation of suspicious lesions. Three readers, blinded to the histopathologic results and images of mpMRI, independently evaluated ADC maps for the detection of PCa. The ADC ratio was defined as the lowest signal intensity (SI) of lesions divided by the SI of normal tissue in the zone of origin. Predictive accuracy of multiparametric and monoparametric MRI were compared using logistic regression analysis. Moreover, both protocols were compared applying goodness-of-fit analysis with the Hosmer-Lemeshow test for continuous ADC ratios and Pearson χ2 test for binary decision calls, correlation analysis with Spearman ρ and intraclass correlation coefficients, as well as noninferiority assessment with a TOST (“two one-sided test”).

Results
Eighty-one histopathologically proven, unique PCa lesions (Gleason score [GS] ≥ 3 + 3) in 52 patients could be unequivocally correlated, with 57 clinically significant (cs) PCa lesions (GS ≥ 3 + 4). Multiparametric MRI detected 95%, and monoparametric ADC detected ratios 91% to 93% of csPCa. Noninferiority of monoparametric MRI was confirmed by TOST (P < 0.05 for all comparisons). Logistic regression analysis revealed comparable predictive diagnostic accuracy of ADC ratios (73.7%–87.8%) versus mpMRI (72.2%–84.7%). Spearman rank correlation coefficient for PCa aggressiveness revealed satisfactory correlation of ADC ratios (P < 0.013 for all correlations). The Hosmer-Lemeshow test for the logistic regression analysis for continuous ADC ratios indicated adequate predictive accuracy (P = 0.55–0.87), and the Pearson χ2 test showed satisfactory goodness of fit (P = 0.35–0.69, χ2 = 0.16–0.87).

Conclusions
Normalized ADC ratios based on advanced DWI are noninferior to mpMRI at 3.0 T for the detection of csPCa in a preselected patient cohort and proved a fast and accurate assessment tool, thus showing a potential prospect of easing the development of future screening methods for PCa.
Association of Cerebral Blood Flow and Brain Tissue Relaxation Time With Neurodevelopmental Outcomes of Preterm Neonates
Authors: Kim Hyun Gi , Choi Jin Wook , Lee Jang Hoon , Jung Da Eun , Gho Sung-Min 
Published: November 2021

Objectives
Both cerebral blood flow (CBF) and brain tissue relaxation times are known to reflect maturation in the neonatal brain. However, we do not yet know if these factors are associated with neurodevelopmental outcomes. The objective of this study was to acquire CBF and relaxation time in preterm neonates, using multidelay arterial spin labeling and synthetic magnetic resonance imaging (MRI), and show their association with later neurodevelopmental outcomes.

Materials and Methods
In this prospective study, preterm neonates were recruited, and multidelay arterial spin labeling and synthetic MRI were performed between September 2017 and December 2018. These neonates underwent the Bayley Scales of Infant Development test at 18 months of age, and both cognitive and motor outcome scores were measured. Transit time–corrected CBF and T1 and T2 relaxation time values were measured for different brain regions. The measured values were correlated with gestational age (GA) at birth and corrected GA at the MRI scan. Simple and multiple linear regression analyses were performed for the measured values and neurodevelopmental outcome scores.

Results
Forty-nine neonates (median [interquartile range] GA, 30 [2] weeks, 209 [17] days; 28 boys) underwent MRI scans at or near term-equivalent age (median [interquartile range] corrected GA, 37 [2] weeks, 258 [14] days). Transit time–corrected CBF (coefficient, 0.31–0.59) and relaxation time (coefficient, −0.39 to −0.86) values showed significant correlation with corrected GA but not with GA. After controlling for GA, the frontal white matter CBF in preterm neonates showed a negative relationship with cognitive outcome scores (β = −0.97; P = 0.029). Frontal white matter T1 relaxation times showed a positive relationship with cognitive outcome scores (β = 0.03; P = 0.025) after controlling for GA.

Conclusions
Higher CBF values and lower T1 relaxation times in frontal white matter were associated with poorer cognitive outcomes. As quantitative neuroimaging markers, CBF and relaxation times may help predict neurodevelopmental outcomes in preterm neonates.
Repeatability and Reproducibility of Computed Tomography Radiomics for Pulmonary Nodules
Authors: Peng Xueqing , Yang Shuyi , Zhou Lingxiao , Mei Yu , Shi Lili , Zhang Rengyin , Shan Fei , Liu Lei 
Published: November 2021

Background
Radiomics can yield minable information from medical images, which can facilitate computer-aided diagnosis. However, the lack of repeatability and reproducibility of radiomic features (RFs) may hinder their generalizability in clinical applications.

Objectives
The aims of this study were to explore 3 main sources of variability in RFs, investigate their influencing magnitudes and patterns, and identify a subset of robust RFs for further studies.

Materials and Methods
A chest phantom with nodules was scanned with different computed tomography (CT) scanners repeatedly with varying acquisition and reconstruction parameters (April-May 2019) to evaluate 3 sources of variability: test-retest, inter-CT, and intra-CT protocol variability. The robustness of the RFs was measured using the concordance correlation coefficient, dynamic range, and intraclass correlation coefficient (ICC). The influencing magnitudes and patterns were analyzed using the Friedman test and Spearman rank correlation coefficient. Stable and informative RFs were selected, and their redundancy was eliminated using hierarchical clustering. Clinical validation was also performed to verify the clinical effectiveness and potential enhancement of the generalizability of radiomics research.

Results
A total of 1295 RFs that showed all 3 sources of variability were included. The reconstruction kernel and the iteration level showed the greatest (ICC, 0.35 ± 0.31) and the least (ICC, 0.63 ± 0.27) influence on magnitudes. The different sources of variability showed relatively consistent patterns of influence (false discovery rate <0.001). Finally, we obtained a subset of 19 stable, informative, and nonredundant RFs under all 3 sources of variability. These RFs exhibited clinical effectiveness and showed better prediction performance than unstable RFs in the validation dataset (P = 0.017, Delong test).

Conclusions
The stability of RFs was affected to different degrees by test-retest and differences in CT manufacturers and models and CT acquisition and reconstruction parameters, but the influences of these factors showed relatively consistent patterns. We also obtained a subset of 19 stable, informative, and nonredundant RFs that should be preferably used to enhance the generalizability of further radiomics research.
Comparative Blink Analysis in Patients With Established Facial Paralysis Using High-Speed Video Analysis
Authors: Ogawa Kazuya , Okazaki Mutsumi , Mori Hiroki , Hidaka Takeaki , Tomioka Yoko , Tanaka Kentaro , Uemura Noriko , Akiyama Masako 
Published: November 2021

Abstract
This study analyzed the blink characteristics of patients with incomplete and complete facial paralysis. The authors measured and compared the palpebral distance, eyelid movement distance, and the eye-closing ratio of blinks in 55 patients with Bell's palsy or Ramsay Hunt syndrome (Bell & Hunt group) and 14 with complete paralysis (Complete Paralysis group). in the Bell & Hunt group, the palpebral distance (7.94 mm) was smaller on the paralyzed side than on the non-paralyzed side (9.61 mm). The eyeclosing ratio and the upper eyelid movement were reduced on the paralyzed side (65.3% versus 93.7%, 4.61 versus 7.97 mm) and in the Complete Paralysis group (25.3% versus 94.7%, 2.10 versus 8.49 mm). In the Bell & Hunt group, movement of the upper eyelid on the paralyzed side was weakened despite palpebral contracture. The Complete Paralysis group exhibited highly reduced movement in both the upper and lower eyelids.
Correlations Between Mandible Condylar Structures and External Ear Deformities in Hemifacial Microsomia With Three-Dimensional Analysis
Authors: Zhang Ziwei , Li Xingzhou , Chen Xiaojun , Sun Mengzhe , Kim Byeong Seop , Aung Zin Mar , Chai Gang 
Published: November 2021

Abstract
This study aimed to explore correlations between mandible and ear deformities and quantitative volumetric relations between condylar structures and external ear in hemifacial microsomia. The authors reconstructed three-dimensional craniofacial models from 212 patients with unilateral hemifacial microsomia (the unaffected side as the controls). Patients were evaluated by Pruzansky-Kaban and Marx classification, and divided into 3 age groups (0–6, 7–12, and >12 years of age). The mandible condylar structures, including condyle and the condylar skeletal unit, were selected (except the classification of the mandibular or ear deformities (M3)). Along with the external ear (except the classification of the mandibular or ear deformities (E4)), their volumes were measured and analyzed. Spearman correlation coefficient analysis was applied. There was a positive correlation between the mandible and ear deformities (r = 0.301, P
< 0.001). Either between the condyle and external ear (P = 0.071–0.493) or between the condylar unit and external ear (P = 0.080 – 0.488), there were no volumetric relations on the affected side, whereas on the unaffected side were (r = 0.492–0.929 for condyle, r = 0.443–0.929 for the condylar unit, P < 0.05). In most cases, the condylar structures of the classification of the mandibular or ear deformities (M2b) were significantly smaller than the classification of the mandibular or ear deformities (M2a). Results suggested deformities of mandibular condylar structures and ear did not correlate, although deformities of mandible and ear did. The condylar deformity might develop independently from microtia and be more severe within relatively more abnormal temporomandibular joints.
Sclerostin Immunohistochemical Staining in Aggressive Maxillofacial Giant Cell Lesions: Initial Results and Potential Therapeutic Target
Authors: Kelly Sean P. , Ramkumar Dipak B. , Lozano-Calderon Santiago A. , Newman Erik T. , Raskin Kevin A. , Chebib Ivan , Schwab Joseph H. , Peacock Zachary S. 
Published: November 2021

Introduction:
Maxillofacial (MF) giant cell lesions (GCLs) are benign, often locally aggressive lesions with potential for recurrence. Systemic treatments have included interferon alpha, calcitonin, bisphosphonates, and denosumab. Sclerostin (SOST) is typically thought to be a negative regulator of bone metabolism and anti-SOST agents have been used to treat osteoporosis; however, its role in central giant cell granuloma is unknown. The purpose of this study was to evaluate the expression of SOST in MF GCLs.

Materials and Methods:
This was a retrospective study of patients with MF GCLs treated at a single institution between 1993 and 2008 with a minimum follow-up of 6 months. Representative tissue was used to create a tissue microarray and SOST immunohistochemical (IHC) staining and grading was performed. The primary outcomes were IHC staining of the stromal cells and giant cells. The secondary outcomes included correlation of IHC staining and patient predictor variables including clinically benign and aggressive lesions. All analyses were completed using univariate statistical tests.

Results:
A total of 37 subjects were included (29 clinically aggressive and 8 clinically benign). Sclerostin staining was present in 30 of 37 subjects (81%). Of these, 22 (60%) had stromal cell staining and 28 (76%) had giant cell staining. The presence or absence of staining, of either cell type, was not associated with aggressiveness, presence of clinical symptoms, tumor size, previous interferon therapy, previous surgery, or the race or age of the patient.

Discussion:
Maxillofacial GCLs have an overall high level of SOST staining; however, the role of SOST in treatment and prognosis is unknown and warrants further study.