bluuebunny/crossref_metadata_2025_split huggingface dataset:
SINGLE INJECTION RESPONSE TO ANTIVASCULAR ENDOTHELIAL GROWTH FACTOR AGENTS IN PATIENTS WITH WET AGE-RELATED MACULAR DEGENERATION
Authors: Bilgic Alper , Kodjikian Laurent , Mathis Thibaud , Sudhalkar Aditya A. , Vasavada Shail A. , Bhojwani Deepak M. 
Published: January 2021

Purpose:
To determine the incidence of complete resolution of choroidal neovascular membrane-associated exudation with a single antivascular endothelial growth factor injection in treatment-naive wet age-related macular degeneration patients and its associated characteristics.

Methods:
Retrospective, observational study of naive wet age-related macular degeneration patients who received antivascular endothelial growth factor therapy with ranibizumab/aflibercept and demonstrated complete resolution of retinal exudation with a single injection. Complete resolution was defined as the total disappearance of the intraretinal fluid, cysts, and subretinal fluid and a return of retinal thickness to <250 μm on spectral-domain optical coherence tomography. All relevant data were collected. Follow-up was scheduled on Days 1, 7, and 30 postoperatively and then monthly, with at least 9 visits mandatory per year if the macula remained fluid free. Appropriate statistical analyses were performed.

Results:
Sixty-three patients (29 men; mean age 67.25 ± 4.40 years) were identified. The mean baseline and final-corrected distance visual acuity was 20/160 and 20/45, respectively. Patients completed a mean of 10.9 follow-up visits per year. Smaller choroidal neovascular membranes (<200 μm), early presentation, better presenting corrected distance visual acuity, subfoveal choroidal neovascular membranes, absence of blood/fibrosis, and use of aflibercept (2 mg) favored resolution with one injection.

Conclusion:
A subset (13.76%; 63/458, 95% confidence intervals: 10.73–17.25) of patients with treatment-naive wet age-related macular degeneration demonstrates resolution of choroidal neovascular membrane-associated exudation with a single antivascular endothelial growth factor injection, sustained over 2 years or more. This can lower therapy costs, treatments, office visits, and the potential risk of geographic atrophy.
SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IMAGING OF THE CHORIOCAPILLARIS
Authors: Ledesma-Gil Gerardo , Fernández-Avellaneda Pedro , Spaide Richard F. 
Published: January 2021

Purpose:
To analyze swept-source optical coherence angiography images acquired at different depths above and below the default location of the Zeiss PLEX Elite 9000.

Methods:
Normal eyes of subjects in their 20s and 30s were evaluated. Angiographic slab images were taken at the default location of 29 µm to 49 µm below the retinal pigment epithelium and 21 µm to 41 µm through 52 µm to 72 µm below in steps. The images were processed using the projection removal function from the device's software. Raw images were evaluated, as were images that underwent a published compensation technique that adjusts for light penetration to the sampled layer.

Results:
Eleven eyes of 11 subjects were evaluated for the uncompensated and the compensated sets with the projection removal function turned off and on. The default location, 29 µm to 49 µm below the retinal pigment epithelium, showed a granular choriocapillaris appearance. This appearance remained in all slabs from each group, differing slightly throughout depth. The projection removal function modified the grayscale values and diminished projection from overlaying retinal vessels. The compensation technique altered the appearance of flow deficits, and the changes induced by it were more evident on the images were the projection removal function was turned on.

Conclusion:
Flow images in swept-source optical coherence angiography of the choriocapillaris from varying levels are similar in appearance, suggesting projection from the choriocapillaris is important in image formation, although layers of vessels in the inner choroid may contribute by various amounts. A model explaining the prominent projection artifacts observed in the choroid with swept-source optical coherence angiography imaging is presented.
THE LONG-TERM EFFECT OF CYSTOTOMY WITH FIBRINOGEN CLOT REMOVAL FOR A CYSTOID MACULAR EDEMA SECONDARY TO IDIOPATHIC MACULAR TELANGIECTASIA TYPE 1: A CASE REPORT
Authors: Maki Hitomi , Imai Hisanori , Yamada Hiroko , Tetsumoto Akira , Hayashida Mayuka , Otsuka Keiko , Miki Akiko , Nakamura Makoto 
Published: January 2021

Purpose:
To report the case of a patient with cystoid macular edema secondary to idiopathic macular telangiectasia (MacTel) Type 1, which was successfully treated by cystotomy and en bloc removal of the fibrinogen-rich component of the cystoid lesion.

Methods:
An 80-year-old man was referred to our department because of a visual defect in his right eye. His best-corrected decimal visual acuity was 0.7 (Snellen equivalent, 20/30). A fundus examination revealed clustered temporal juxafoveal microaneurysms and foveal cystoid macular edema. The patient refused to undergo conventional treatments, including direct retinal photocoagulation for microaneurysms, intravitreal anti–vascular endothelial growth factor injection, and intravitreal triamcinolone injection. However, he provided consent to undergo cystotomy and en bloc removal of the fibrinogen-rich component of the cystoid lesion.

Results:
His best-corrected decimal visual acuity was 0.2 (Snellen equivalent, 20/100) just before the surgery. A 27-gauge vitrectomy with internal limiting membrane peeling was performed. Cystotomy was performed during the surgery, and the fibrinogen clot visible in the cystoid cavity was also removed. Cystoid macular edema rapidly disappeared after the surgery. Three years postoperatively, the patient had best-corrected decimal visual acuity of 0.5 (Snellen equivalent, 20/40) at the last medical examination, and the cystoid macular edema had not recurred.

Conclusion:
Cystotomy and en bloc removal of the fibrinogen-rich component of the cystoid lesion could be valid treatment options for cystoid macular edema secondary to MacTel Type 1.
IBRUTINIB FOR CONTROL OF CHOROIDAL AND ORBITAL METASTASIS FROM CHRONIC LYMPHOCYTIC LEUKEMIA
Authors: Sieburth Rebecca M. , Weaver Christopher D. , Kirzhner Maria , Shildkrot Yevgeniy 
Published: January 2021

Purpose:
To describe a case of choroidal and orbital metastasis of chronic lymphocytic leukemia controlled with ibrutinib monotherapy, an oral tyrosine kinase inhibitor.

Methods:
Single case report.

Results:
A 69-year-old man with a past medical history of chronic lymphocytic leukemia diagnosed 1 year previously was referred with a foveal lesion in the right eye and was found to have hyperopic shift in the right eye. Optical coherence tomography demonstrated choroidal infiltration in the right eye, and computed tomography of the orbits demonstrated a left orbital mass. Biopsy of the left orbital mass confirmed chronic lymphocytic leukemia/small lymphocytic leukemia. Oral ibrutinib monotherapy of 140 mg three times daily was initiated for treatment of these choroidal and orbital metastases, and at 6 months, there was clinical resolution of disease. Cessation of ibrutinib monotherapy was followed 7 months later by recurrence of choroidal disease. Reinitiation of ibrutinib monotherapy 140 mg three times daily led again to clinical disease resolution, and durable remission has been attained on a well-tolerated low maintenance dose of ibrutinib 140 mg two times daily.

Conclusion:
This is the first reported case of control of choroidal and orbital metastasis of chronic lymphocytic leukemia with ibrutinib monotherapy, confirmed with choroidal recurrence on drug cessation and clinical resolution of disease on re-treatment.
Comparative Analysis of the Clinical Aspects and Treatment Outcomes of Stenotrophomonas maltophilia Keratitis and Pseudomonas aeruginosa Keratitis
Authors: Cho Chan-Ho , Lee Sang-Bumm 
Published: January 2021

Objectives:
We analyzed the clinical aspects and treatment outcomes of Stenotrophomonas maltophilia (SM) keratitis and Pseudomonas aeruginosa (PA) keratitis.

Methods:
Medical records of 55 inpatients with culture-proven SM (n=21) and PA (n=34) keratitis were retrospectively reviewed. Predisposing factors, clinical characteristics, and treatment outcomes were compared between the SM and PA groups.

Results:
The mean symptom duration was longer in the SM group than in the PA group (10.4:4.3 days; P=0.012). The most common predisposing factor was corneal trauma (47.6%) in the SM group and contact-lens wear (38.2%) in the PA group. There were no differences in the mean epithelial defect size (12.7:11.9 mm2; P=0.861), hypopyon (33.3%:44.1%; P=0.428), surgical treatment (4.8%:14.7%; P=0.390), or poor clinical outcomes (26.8%:30.3%; P=0.760) between the SM and PA groups. In multivariate logistic regression, risk factors for poor clinical outcomes were hypopyon (odds ratio [OR], 52.00; P=0.010) in the SM group and symptom duration≥7 days (OR, 44.32; P=0.015), age≥60 years (OR, 21.13; P=0.019), and hypopyon (OR, 15.20; P=0.038) in the PA group.

Conclusion:
Compared with PA keratitis, SM keratitis had slower progression, and its clinical characteristics and treatment results were not worse. In both groups, hypopyon was the risk factor for a poor clinical outcome.
The Impacts of Face Mask Use on Standard Automated Perimetry Results in Glaucoma Patients
Authors: Bayram Nurettin , Gundogan Medine , Ozsaygili Cemal , Vural Esra , Cicek Ayse 
Published: January 2021

Purpose:
The coronavirus disease 2019 (COVID-19) spread rapidly worldwide, causing a severe outbreak. Because the disease is easily transmitted, face masks are a vital tool to slow the spread. The aim of this study is to investigate the impacts of face mask use on standard automated perimetry (SAP) results in glaucoma patients.

Materials and Methods:
All follow-up glaucoma patients who underwent SAP between May and October 2020 were enrolled in this study. In patients with low test reliability and/or visual field changes, SAP was repeated after repositioning and taping patients’ face masks.

Results:
A total of 127 patients (59 female and 68 male) with a mean age of 59.8±10.3 years were included in the study. While 101 patients (79.5%) wore surgical face masks, 26 patients (20.5%) wore cloth face masks. Low SAP reliability appeared in 23 patients (18.1%), and inferior visual field defects were present in 3 patients (2.4%). The main effects of poorly fitting face masks on SAP reliability were increased fixation losses and false-positive errors (for both, P=0.001). Low SAP reliability was significantly higher in patients wearing cloth face masks than in those wearing surgical face masks (47.8% vs. 9.9%; P=0.0001). The face mask–related fogging of eyeglasses before SAP is a strong predictor of fogging of the trial lenses–related low SAP reliability (odds ratio: 27, 95% confidence interval: 5.48-132.92, P=0.0001). In all repeated SAPs, the patients’ reliability parameters improved, and inferior visual field artifacts disappeared.

Conclusions:
Unsuitable face masks can cause either visual field artifacts, which may be interpreted as glaucoma progression or low test reliability. Taping the face masks’ upper edges is an effective technique to prevent visual field artifacts and obtain good test reliability.
High Prevalence of Nontuberculous Mycobacteria in Cystic Fibrosis Patients in Tropical French Reunion Island
Authors: Ho Didier , Belmonte Olivier , Andre Michel , Gazaille Virgile , Perisson Caroline , Gachelin Elsa , Allyn Jérôme , Payet Annabelle , Coolen-Allou Nathalie 
Published: January 2021

Background:
Reunion Island is a French overseas department located in a tropical area, where cystic fibrosis incidence is high. Cystic fibrosis (CF) patients are at risk of developing nontuberculous mycobacteria (NTM) infection. Epidemiologic studies are lacking in Reunion Island.

Methods:
From 2002 to 2015, a retrospective review was performed in university hospitals on Reunion Island. All CF patients having at least 1 positive NTM isolate were included. Clinical, radiologic, and microbiologic data were collected from patient records.

Results:
Fifty-one CF patients were included. The overall estimated prevalence of NTM was 26.4% in total CF population and 36.9% in patients over 12 years of age. Mycobacterium abscessus and Mycobacterium avium were the most frequently identified species found in 31 patients (60.8%) and 14 patients (27.4%), respectively. A rare NTM species: Mycobacterium simiae was found in 4 patients (7.8%). Twenty-nine patients (56.9%) met the American Thoracic Society (ATS) criteria for infection. They were more likely younger with a low body mass index and more frequently infected by Mycobacterium abscessus (22/29).

Conclusion:
The overall prevalence of NTM in tropical Reunion Island is 3 times higher than in metropolitan France. A different environmental exposure in a tropical climate or risk factors related to cystic fibrosis or its treatment in Reunion patients could explain it.
Evaluation of COVID-19 Vaccine Refusal in Parents
Authors: Yigit Metin , Ozkaya-Parlakay Aslinur , Senel Emrah 
Published: January 2021

Objective:
The frequency of vaccine refusal, which is associated with many factors, is increasing worldwide. The aim of this study was to predict the frequency of vaccine refusal against domestic and foreign COVID-19 vaccines and identify the factors underlying refusal.

Methods:
A survey consisting of 16 questions about COVID-19 vaccination was conducted either face-to-face or online with 428 parents who agreed to participate in the study. The parents had children who were inpatients or outpatients in the Children’s Hospital of Ankara City Hospital. In the survey, parents were asked about family sociodemographic characteristics, opinions on domestic and foreign COVID-19 vaccines, and reasons for vaccine refusal.

Results:
While 66.1% of parents were reluctant to receive foreign COVID-19 vaccines, only 37.4% were reluctant to receive domestic COVID-19 vaccines. The participants’ preference for the domestic vaccine was significantly higher for themselves and their children (P < 0.05). Women were less likely to be willing to receive foreign vaccines than men (P < 0.05). As the education level increased, fewer parents preferred the domestic vaccine for themselves (P = 0.046) and their children (P = 0.005). Both domestic and foreign vaccine acceptability for parents and their children was higher among parents with high anxiety levels regarding COVID-19 infection (P < 0.05). The most common reasons for refusal were anxiety about vaccine side effects, lack of knowledge about the effectiveness of vaccines, and distrust of vaccines originating from abroad.

Conclusion:
Most of the participants were hesitant about COVID-19 vaccines. This study demonstrates that vaccine uptake can be increased by considering the higher preference for domestic vaccines.
Skin Cancer: Back to Basics
Authors: Onoday Heather 
Published: January 2021

ABSTRACT
There are more than a million cases of cutaneous squamous cell carcinoma that occur annually, with incidences increasing over the past 30 years. This common skin cancer has a variety of risk factors, with ultraviolet radiation and increasing age being two of the greatest known associated risks. This article is a review of the epidemiology and other risk factors of this common skin cancer and is also an update on its pathophysiology and treatment.
Multistakeholder Perceptions on Lower-Limb Prosthetic User Requirements and the Development of Neuroprostheses: A Contextual Inquiry
Authors: Valgeirsdóttir Vigdís Vala , Sigurðardóttir Jóna Sigrún , Jóhannesson Ómar I. , Alexandersson Ásgeir , Kristjánsson Árni 
Published: January 2021

ABSTRACT

Introduction
Neuroprosthetic systems that can work with prosthetic legs are currently being developed to provide individuals with lower-limb amputation with intent control over their device and sensory feedback. No such system is commercially available, and the effects of providing functions that have previously not been available to lower-limb prosthetic users are unclear.

Methods
Here we present investigations of the perceptions of multiple stakeholders (prosthetic users, physician, psychologist, physiotherapist, prosthetist, and groups of prosthetic designers and engineers) on prosthetic user problems and the development of neuroprosthetics. The investigation entailed semistructured interviews, focus group discussions, and a contextual inquiry.

Results
Our findings indicate that prosthetic users may face several challenges that can potentially be addressed via neurological interfacing. We further identified criteria perceived as integral for the development of lower-limb neuroprostheses as well as considerations for the actualization of a usable system that reaches end users.

Conclusions
On the whole, the field of neuroprosthetics has great potential to increase the wellbeing, mobility, and quality of life of persons with lower-limb amputation.
A National Survey of Student Loan Debt Accrued by Doctor of Physical Therapy Students
Authors: Berry Justin W. 
Published: January 2021

Introduction.
Increasing levels of student loan debt are a concern within many health professions, including physical therapy. This purpose of this study was to determine the levels and potential repayment of student loan debt for graduates of public and private physical therapist educational programs and to determine the relationship between debt management education, student loan debt, and credit card debt in Doctor of Physical Therapy (DPT) students just prior to graduation.

Methods.
Seven hundred thirty-three final year DPT students scheduled to graduate in spring or summer of 2019 completed a survey asking participants their level of student loan and credit card debt; their concerns regarding student loan debt; and if their educational program included curricular information on debt management.

Results.
Ninety-one percent of participants had some level of student loan debt. For participants with student loan debt, the average total student debt balance at the time of graduation was $103,482 for those attending a public institution and $138,361 for those attending a private institution; with the average amount of student loans taken out just for attending a DPT program being $83,087 for those attending a public institution and $112,207 for those attending a private institution. Participants who received debt management education within their DPT program had, on average, $3,520 less student loan debt for attending their DPT program and $570 less credit card debt than those who did not receive this education. For participants with student loans, 81% were concerned about loan repayment and 90.3% were concerned about the ability to make future major purchases, such as a house or car.

Discussion and Conclusion.
Utilizing participants' average estimated starting salary and a 15% debt to income guideline, 75.1% of participants with student loan debt would not meet 10-year loan repayment guidelines, 38.7% would not meet fixed 25-year loan repayment plan guidelines, and 21.4% would not meet 25-year graduated loan repayment plan guidelines. There was no significant difference in debt levels between students who did and did not receive debt management education within their DPT educational programs.
Outcomes of 2 Multimodal Human Anatomy Courses Among Doctor of Physical Therapy Students (Entry-Level): A Quasi-experimental Study
Authors: Maher Sara F. , Doherty Deborah J. 
Published: January 2021

Introduction.
Alternative methods of anatomy instruction have increased in popularity; however, cadaveric dissections were not consistently reported as the most effective teaching tool. Subjects from 2 professional (entry-level) physical therapist education programs who were taught anatomy using multimodal strategies and either cadaveric dissection or prosected cadavers were compared. The purposes of this study were to 1) determine subjects' approach to learning (surface or deep), 2) determine the preferred learning style of the subjects, 3) assess the subjects' retention of anatomy at the completion of an anatomy course and 6 months later, and 4) determine how much time subjects spent in learning activities for each anatomy pedagogy.

Methods.
Outcome measures consisted of an anatomy quiz, the Revised 2-Factor Study Process Questionnaire, a Learning Perception Inventory, and the Visual, Auditory, Read/Write, Kinesthetic Questionnaire. Data were collected at 3 points during the study: before anatomy class, immediately at the conclusion of the anatomy class, and 6 months after the class had ended. Data were analyzed using SPSS 25.0 and included descriptive statistics, Wilcoxon signed ranks tests, and Mann–Whitney U tests.

Results.
Subjects in both programs were kinesthetic learners who used a deep learning approach. Subjects were able to retain anatomical knowledge postanatomy and 6 months after the class ended, no matter which learning tools were used. The group who worked with prosected cadavers perceived spending more total time preparing for anatomy class.

Discussion and Conclusion.
Based on these results, cadaveric prosection was as effective as cadaveric dissection in 2 multimodal anatomy classes for subjects in 2 professional (entry-level) physical therapist education programs.
Current Practices in Tranexamic Acid Administration for Pediatric Trauma Patients in the United States
Authors: Cornelius Brian , Cummings Quinn , Assercq Mathieu , Rizzo Erin , Gennuso Sonja , Cornelius Angela 
Published: January 2021

Background
Although controversial, early administration of tranexamic acid (TXA) has been shown to reduce mortality in adult patients with major trauma. Tranexamic acid has also been successfully used in elective pediatric surgery, with significant reduction in blood loss and transfusion requirements. There are limited data to guide its use in pediatric trauma patients. We sought to determine the current practices for TXA administration in pediatric trauma patients in the United States.

Methods
A survey was conducted of all the American College of Surgeons-verified Level I and II trauma centers in the United States. The survey data underwent quantitative analysis.

Results
Of the 363 Level I and II qualifying centers, we received responses from 220 for an overall response rate of 61%. Eighty of 99 verified pediatric trauma centers responded for a pediatric trauma center response rate of 81%. Of all responding centers, 148 (67%) reported they care for pediatric trauma patients, with an average of 513 pediatric trauma patients annually. The pediatric trauma centers report caring for an average of 650 pediatric trauma patients annually. Of all centers caring for pediatric trauma, 52 (35%) report using TXA, with the most common initial dosing being 15 mg/kg (68%). A follow-up infusion was utilized by 45 (87%) of the programs, most commonly dosed at 2 mg/kg/hr × 8 hr utilized by 24 centers (54%).

Conclusion
Although the clinical evidence for TXA in pediatric trauma patients is limited, we believe that consideration should be given for use in major trauma with hemodynamic instability or significant risk for ongoing hemorrhage. If available, resuscitation should be guided by thromboelastography to identify candidates who would most benefit from antithrombolytic administration. This represents a low-cost/low-risk and high-yield therapy for pediatric trauma patients.