bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pupil Size in Outdoor Environments
Authors: Harley Stephanie K. , Sliney David H. 
Published: July 2018

Abstract
When addressing the risk of laser-induced retinal injury in daylight, an individual’s pupil size (diameter) is of great importance since the retinal illumination varies as the square of the pupil size. Pupil size was measured under daylight conditions for 87 subjects to fill the data gap in over a century of laboratory pupillometry studies. Photography with a fixed chin/head rest and digital camera platform was employed to measure pupil diameter of subjects viewing a full-field neutral screen. The digital images of the pupils of 87 subjects were measured using computer software. Screen luminance values ranged between 790 cd m−2 to 4,300 cd m−2. The average pupil size for this study was 2.39 mm for an average luminance of 1,473 cd m−2. Pupil size measurements ranged from 1.44 mm to 3.03 mm. The data were stratified over luminance intervals, sex, eye color, and age.
Estimating Thyroid Doses From Modified Barium Swallow Studies
Authors: Bonilha Heather Shaw , Wilmskoetter Janina , Tipnis Sameer V. , Martin-Harris Bonnie , Huda Walter 
Published: July 2018

Abstract
This study sought to obtain factors to convert entrance air kerma into thyroid doses for patients undergoing modified barium swallow studies. A commercial software package (PCXMC 2.0.1) was used to calculate patient thyroid doses from modified barium swallow studies, which were divided by the entrance air kerma to yield f

thyroid
ratios. Exposure in the lateral and posterior-anterior projections were considered where the thyroid was directly irradiated. Calculations were obtained for adult patients as well as children ranging from birth to 10 y old. The average value of f

thyroid
in a normal-sized adult was 0.63 ± 0.11 in the lateral projection and 0.18 ± 0.06 for an upper gastrointestinal posterior-anterior projection. Increasing the beam quality from the lowest (60 kV + 3 mm aluminum) to the highest (110 kV + 3 mm aluminum + 0.2 mm copper) values investigated nearly doubled the value of f

thyroid
from 0.42 to 0.79 in the lateral projection and quadrupled the value from 0.07 to 0.29 in the upper gastrointestinal posterior-anterior projection. Values of f

thyroid
decreased with increasing body mass index. Average values of f

thyroid
in 10 y olds were similar to those of adults but always increased as the age of the exposed child was reduced. The average f

thyroid
for newborns was 0.84, nearly one-third higher than the corresponding ratio for normal-sized adults.
A New Feasible Syncope Risk Score Appropriate for Emergency Department: A Prospective Cohort Study
Authors: Bozorgi Ali , Hosseini Kaveh , Jalali Arash , Tajdini Masih 
Published: July 2018

Background:
We aimed to compare current syncope risk stratification scores and propose a new more feasible and easy-to-use one.

Methods:
In this prospective cohort study, we enrolled all patients (≥18 years) with chief complaint of syncope if they were not eligible for admission in terms of high-risk features. San Francisco Syncope Rule, Osservatorio Epidemiologico sulla Sincope nel Lazio, and risk stratification of syncope in the emergency department scores were compared in our population.

Results:
Overall, 356 patients (mean age: 44.5 years, 46.3% male) were followed for 3 months. Serious adverse events occurred in 26 (7.3%) patients including 4 deaths. Odds ratio for adverse events was 6.8 [95% confidence interval (CI), 2.8–16.1; P < 0.001; area under the curve (AUC): 66.3], 7.7 (95% CI, 3.2–18; P < 0.001; AUC: 72.8), and 18 (95% CI, 7.1–45.4; P < 0.001; AUC: 70.8) when considering San Francisco Syncope Rule, Osservatorio Epidemiologico sulla Sincope nel Lazio, and risk stratification of syncope in the emergency department scores as the predicting tools, respectively. We proposed a relatively more feasible risk score (presenting symptoms, history of cardiovascular diseases, ejection fraction <50%, and predefined electrocardiography abnormalities). According to this syncope score, odds ratio for occurring adverse events was 20.9 (95% CI, 8.4–52; P < 0.001; AUC: 79.8).

Conclusions:
The 3 syncope risk scores could somehow predict 3-month adverse events. We found more feasible indicators that could predict serious events better. It suits well for emergency department.
OPTICAL COHERENCE TOMOGRAPHY, FLUORESCEIN ANGIOGRAPHY, AND DIAGNOSIS OF CHOROIDAL NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION
Authors: Gualino Vincent , Tadayoni Ramin , Cohen Salomon Yves , Erginay Ali , Fajnkuchen Franck , Haouchine Belkacem , Krivosic Valérie , Quentel Gabriel , Vicaut Eric , Gaudric Alain 
Published: July 2018

Purpose:
To determine the sensitivity and specificity of different retinal imaging combinations for the diagnosis of choroidal neovascularization (CNV) in age-related macular degeneration.

Methods:
Patients aged 50 years or older referred for suspicious recent-onset CNV related to age-related macular degeneration were prospectively included for 6 months. Data recorded included color fundus photographs (CFPs), spectral domain optical coherence tomography (SD-OCT), and fluorescein angiography (FA) images. Five retina specialists randomly interpreted SD-OCT combined with CFP, and then FA combined with CFP. The reference diagnosis of CNV was based on the agreement of two readers in the interpretation of the SD-OCT + FA + CFP combination.

Results:
One hundred and forty-eight patients (148 eyes) were included. For the diagnosis of CNV, the sensitivity of both SD-OCT + CFP and FA + CFP was of 90.9%. Type 2 CNV was diagnosed in 98% to 100% of cases with SD-OCT + CFP or FA + CFP, whereas Type 1 CNV was diagnosed in 82.9% of cases with SD-OCT + CFP and 81.6% with FA + CFP.

Conclusion:
When used as a first diagnostic test, SD-OCT combined with CFP had sensitivity and specificity similar to those of FA combined with CFP, for the diagnosis of CNV in age-related macular degeneration. This shows the increasingly important role of SD-OCT as a first-line test in the diagnosis of CNV.
PHARMACOTHERAPEUTIC CLOSURE OF A PERSISTING TRAUMATIC MACULAR HOLE WITH INTRAOCULAR STEROIDS
Authors: Venkatesh Ramesh , Yadav Naresh K. , Jain Nimesh , Sinha Shivani , Mehta Ruchir 
Published: July 2018

Purpose:
To report a case of successful closure of traumatic macular hole after treatment with intraocular steroids in a nonvitrectomized eye.

Methods:
Retrospective observational case report.

Case description:
A 34-year-old man developed a full-thickness macular hole and submacular bleed after injury with firecracker in the left eye. Visual acuity in the left eye was counting fingers close to face. Intraocular gas, 0.3 cc of 100% SF6, was injected for displacement of submacular bleed. At 2 months after presentation, macular hole persisted with signs of intraocular inflammation. A trial of intraocular triamcinolone injection (2 mg in 0.05 ml) was given, which resulted in complete closure of macular hole and improvement in visual acuity to 6/36 and thereby avoiding the need for ocular surgery.

Conclusion:
Ocular steroids could play an important role in successful closure of persisting macular holes in a setting of blunt trauma, especially in a background of uveitis.
Conjunctival Eosinophilic Masses With Chronic Eosinophilic Pneumonia
Authors: Nagamoto Takashi , Mizuno Yoshinobu , Shigeyasu Chika , Fukui Masaki , Yamada Masakazu 
Published: July 2018

Purpose:
To report a case of ocular findings associated with chronic eosinophilic pneumonia (CEP).

Case:
A 63-year-old man was referred to the National Institution of Hospital Organization Tokyo Medical Center with bilateral eyelid swelling due to giant papillomatous changes, each measuring approximately 10 mm in diameter with severe hyperemia on the tarsal conjunctiva. He was followed for CEP for 8 years and systemically treated with 6 mg oral prednisolone for an average of 5 years. Because the lesions did not respond to topical 0.1% tacrolimus and 0.025% levocabastine treatment and because an increase in intraocular pressure was found to occur as a side effect of 0.01% betamethasone instillation for several months, we performed surgical resection of the bilateral conjunctival lesions. Histopathological findings revealed extreme eosinophil, plasma cell, and lymphocytic infiltration and interstitial fibrosis. These conjunctival specimen findings were similar to those seen in the alveolar lesions in CEP. Topical antiinflammatory therapy using 0.1% tacrolimus eye drops was administered after surgery, which relieved the patient's lid swelling and itching. However, the lesions concurrently changed to be consistent with exacerbation and remission of systemic CEP.

Conclusions:
Based on the clinical course and histopathology, the conjunctival proliferative masses in our case were assumed to be associated with CEP.
Bacterial Sexually Transmitted Infection Screening Rates by Symptomatic Status Among Men Who Have Sex With Men in the United States: A Hierarchical Bayesian Analysis
Authors: Jenness Samuel M. , Weiss Kevin M. , Prasad Pragati , Zlotorzynska Maria , Sanchez Travis 
Published: July 2018

Background
Prevention of bacterial sexually transmitted infections (STIs) among men who have sex with men (MSM) requires timely disease detection, but this is complicated by asymptomatic infection. We estimated screening/testing rates by symptomatic status to evaluate adherence to Centers for Disease Control and Prevention STI screening guidelines.

Methods
In a cross-sectional study of 2572 US MSM aged 15 to 65 years in 2017 to 2018, we measured the reported number of asymptomatic STI screens in the past 2 years versus tests prompted by disease symptoms. Using negative binominal regression within a hierarchical Bayesian framework, we estimated yearly rates of asymptomatic screening and symptomatic testing by geographic, demographic, and behavioral factors.

Results
Human immunodeficiency virus (HIV) status was most strongly associated with all testing/screening frequency (incidence rate ratio [IRR], 1.72; 95% credible interval [Crl], 1.49, 1.97). The HIV-uninfected MSM had 0.14 (95% credible interval [CrI], 0.12–0.17) symptomatic tests and 0.88 (95% CrI, 0.77–1.01) asymptomatic screens per year. The HIV-infected MSM had 0.25 (95% CrI, 0.18–0.35) symptomatic tests and 1.53 (95% CrI, 1.24–1.88) asymptomatic screens per year. Rates of asymptomatic screening were higher among black compared with white MSM (IRR, 1.41; 95% CrI, 1.15–1.73), but weakly associated with number of past-year sexual partners (IRR, 1.01; 95% CrI, 1.00–1.01). Overall, 85% to 90% of diagnostic events were asymptomatic screens.

Conclusions
Self-reported rates of STI screening were close to Centers for Disease Control and Prevention's recommended overall annual screening frequency, but with gaps defined by demographics and behavioral risk. Targeted screening efforts may be indicated specifically for younger MSM and those with multiple partners.
Preexposure Prophylaxis for Human Immunodeficiency Virus (HIV) Prevention Among HIV–uninfected Pregnant Women: Estimated Coverage Using Risk-based Versus Regional Prevalence Approaches
Authors: Pintye Jillian , Singa Benson , Wanyonyi Kennedy , Itindi Janet , Kinuthia John , Langat Agnes , Nganga Lucy , Katana Abraham , Baeten Jared M. , McGrath Christine J. , John-Stewart Grace 
Published: July 2018

Abstract
Antenatal register data from 62 clinics in 5 regions of Kenya were used to estimate women with human immunodeficiency virus (HIV) risk (partner HIV status, syphilis). With individual risk-guided preexposure prophylaxis (PrEP) offer in all regions, 39% of pregnant women would be offered PrEP nationally. Offering PrEP to all women in high-prevalence regions reached 26% of the pregnant women.
Adherence to Guidelines in the Treatment of Diabetic Ketoacidosis in Children
Authors: Weinberger Katharina , Seick Barbarini Daniela , Simma Burkhard 
Published: July 2018

Background
The aim of this study is to assess the adherence of Austrian physicians to International Society for Pediatric and Adolescent Diabetes guidelines 2009 concerning treatment in diabetic ketoacidosis and whether there is a difference between specialty (endocrinologists or intensivists) or clinical experience.

Patients and Methods
An online questionnaire was sent to members of the working groups of the Austrian Society of Pediatric and Adolescent Medicine.

Results
Of 106 questionnaires, 56 were included in the analysis. The mean ± SD overall adherence was 60 ± 23.5%. Endocrinologists showed a nonsignificant higher result, related to a significant higher adherence regarding the amount of fluids (P < 0.05) and tendency to bicarbonate use (P = 0.052) respectively. No differences were found between participants with different clinical experience. All gave crystalloids, 55% administered initial bolus of 10 to 20 mL/kg per hour, 58% used 1.5 to 2 times fluid maintenance, 87% started insulin after first fluid bolus, 28% gave 0.05 and 0.1 IE/kg per hour to infants and children respectively, and 43% 0.05 IE/kg per hour to all patients. When blood glucose falls, 53% gave glucose and 47% reduced insulin. In cerebral edema, 46% gave at least 2 of 3 recommended measures (fluid reduction, mannitol, or hypertonic saline). In acidosis (pH <6.9), 25% administered bicarbonate (as per guideline) and 52.9% never gave bicarbonate.

Conclusions
Adherence to the actual guidelines is 60% and does neither depend on speciality nor on clinical routine. Essential treatment measures (eg, amount of fluids, consequence of rapid glucose fall, bicarbonate use) are not commonly known.
A Case Report of Pediatric Paraneoplastic Dysautonomia
Authors: Harer Katherine , Mann Jennifer , Muhlbauer Nicole , Welch Jennifer , Alverson Brian 
Published: July 2018

Abstract
We present the case of a 16-year-old girl who presented with severe refractory orthostatic hypotension secondary to pandysautonomia. Initially, she was treated for Guillain-Barré syndrome given clinical symptoms and increased protein on cerebrospinal fluid, but the severity of symptoms and lack of response to intravenous immunoglobulin prompted further evaluation for an autoimmune etiology. She was ultimately diagnosed with paraneoplastic neuropathy secondary to Hodgkin lymphoma. Paraneoplastic neurologic phenomena are rare, occurring in just 0.01% of cancers, and prompt recognition is crucial for initiating appropriate therapy. Rapid progression of severe disabling symptoms should raise suspicion for an underlying malignancy. The patient had limited response to splanchnic vasoconstrictors in addition to α-agonists, anticholinergics, and mineralocorticoids until initiation of modified Hodgkin lymphoma directed chemotherapy plus rituximab.
Effectiveness of Canakinumab in Colchicine- and Anakinra-Resistant or -Intolerant Adult Familial Mediterranean Fever Patients
Authors: Babaoglu Hakan , Varan Ozkan , Kucuk Hamit , Atas Nuh , Satis Hasan , Salman Reyhan , Ozturk Mehmet Akif , Goker Berna , Tufan Abdurrahman , Haznedaroglu Seminur 
Published: July 2018

Objective
We aimed to present our single-center real-life experience of canakinumab use in adult patients with familial Mediterranean fever (FMF).

Methods
Data were derived from the Gazi FMF cohort, which was established in 2010. From that year, all patients with FMF were registered. The impact of FMF on their lives was tracked by either an FMF diary or mobile phone application (FMF-AIDD, free to download in App Store and Google Play). The records of patients who were treated with canakinumab were reviewed.

Results
Twenty-three adult patients with FMF (65% female) were enrolled in this study. The median age was 32 years (min–max, 24–58 years), and the disease duration was 26 years (14–59 years). A total of 86% of patients harbored homozygous or compound heterozygous exon 10 MEFV mutations. Indications for interleukin 1 inhibitor use were colchicine resistance (n = 12) or intolerance (n = 2), amyloidosis (n = 7), and chronic manifestations of the disease (n = 2). All patients used anakinra before. The median duration of canakinumab use was 7 months (min–max, 1–44 months). Pre- and post-canakinumab periods were compared. Attack severity, duration, frequency, C-reactive protein level, and erythrocyte sedimentation rate were significantly improved (p ≤ 0.01), whereas serum creatinine and alanine aminotransferase levels remained the same (p = 0.27 and p = 0.74, respectively). Canakinumab achieved complete disease remission in 14 patients (60%). Canakinumab was discontinued in 7 patients. The reasons for discontinuation were pregnancy (n = 2), dominance of axial spondyloarthropathy (n = 2), inflammatory bowel disease, patient's refusal, and weight gain.

Conclusions
Canakinumab is effective in the prevention of FMF bouts without severe adverse effects. Treatment with canakinumab in an individualized dose and interval may be a reasonable choice for colchicine- and anakinra-resistant or -intolerant adult patients with FMF and those with chronic manifestations of disease.
Reduced Postburn Hypertrophic Scarring and Improved Physical Recovery With Yearlong Administration of Oxandrolone and Propranolol
Authors: Herndon David , Capek Karel D. , Ross Evan , Jay Jayson W. , Prasai Anesh , Ayadi Amina El , Foncerrada-Ortega Guillermo , Blears Elizabeth , Sommerhalder Christian , McMullen Kara , Amtmann Dagmar , Cox Robert , Hundeshagen Gabriel , Jennings Kristofer , Sousse Linda E. , Suman Oscar E. , Meyer Walter J. , Finnerty Celeste C. 
Published: July 2018

Background:
Massive burns induce a hypermetabolic response that leads to total body wasting and impaired physical and psychosocial recovery. The administration of propranolol or oxandrolone positively affects postburn metabolism and growth. The combined administration of oxandrolone and propranolol (OxProp) for 1 year restores growth in children with large burns. Here, we investigated whether the combined administration of OxProp for 1 year would reduce scarring and improve quality of life compared with control.

Study Design:
Children with large burns (n = 480) were enrolled into this institutional review board-approved study; patients were randomized to control (n = 226) or administration of OxProp (n = 126) for 1 year postburn. Assessments were conducted at discharge and 6, 12, and 24 months postburn. Scar biopsies were obtained for histology. Physical scar assessments and patient reported outcome measures of physical and psychosocial function were obtained.

Results:
Reductions in cellularity, vascular structures, inflammation, and abnormal collagen (P < 0.05) occurred in OxProp-treated scars. With OxProp, scar severity was attenuated and pliability increased (both P < 0.05). Analyses of patient-reported outcomes showed improved general and emotional health within the OxProp-treated group (P < 0.05).

Conclusions:
Here, we have shown improvements in objective and subjective measures of scarring and an increase in overall patient-reported physical function. The combined administration of OxProp for up to a year after burn injury should be considered for the reduction of postburn scarring and improvement of long-term psychosocial outcomes in children with massive burns.
The Clinical Significance of Breast-only and Node-only Pathologic Complete Response (pCR) After Neoadjuvant Chemotherapy (NACT)
Authors: Fayanju Oluwadamilola M. , Ren Yi , Thomas Samantha M. , Greenup Rachel A. , Plichta Jennifer K. , Rosenberger Laura H. , Tamirisa Nina , Force Jeremy , Boughey Judy C. , Hyslop Terry , Hwang E. Shelley 
Published: July 2018

Objective:
To determine whether the association between overall survival (OS) and response to neoadjuvant chemotherapy (NACT) in breast cancer patients varies with tumor subtype and anatomic extent of pathologic complete response (pCR).

Background:
pCR after NACT predicts improved OS in breast cancer, but it is unclear whether pCR limited to the breast or axilla is also associated with OS.

Methods:
Women with cT1-3/cN0-1 breast cancer diagnosed in 2010 to 2014 who underwent surgery following NACT were identified in the NCDB and divided into 4 subtypes based on reported hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. Kaplan-Meier curves and Cox proportional hazards models were used to estimate OS. Multivariate logistic regression was used to identify factors associated with post-NACT response, defined as upstage (yp stage>clinical stage); no change (clinical stage = yp stage); overall (breast+axilla, ypT0N0), breast-only (ypT0N1/N1mic), or node-only (ypT1-3N0) pCR.

Results:
Of 33,162 identified patients, 20,265 experienced overall pCR (n = 6370, 19.2%), breast-only pCR (n = 494, 1.5%), node-only pCR (n = 1133, 3.4%), no stage change (n = 9641, 29.1%), or upstage (n = 2627, 7.9%). Compared with no stage change, breast-only pCR was associated with improved OS in triple-negative disease [hazard ratio = 0.58, 95% confidence interval (95% CI) = 0.37–0.89], and node-only pCR was associated with improved OS in both triple-negative (hazard ratio = 0.55,95% CI = 0.39–0.76) and HR+/HER2− disease (hazard ratio = 0.54, 95% CI = 0.33–0.89). For patients achieving overall (breast+axilla) pCR, unadjusted 5-year OS was 0.94 (95% CI = 0.93–0.95), with no difference between patients who were cN0 (hazard ratio = 0.95, 95% CI = 0.93–0.96) or cN1 (hazard ratio = 0.94, 95% CI = 0.92–0.96) at diagnosis.

Conclusions:
In node-positive patients, pCR limited to either the breast or axilla predicts survival for select receptor subtypes. In patients achieving pCR in both the breast and axilla, survival is driven by response to NACT rather than presenting cN stage.