bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison of Quantitative Mapping and Stereoscopic Fundus Photography Grading of Retinal Thickness in Diabetic Eyes With Macular Edema
Authors: Yang Yunsik , Vitale Susan , Ding Yulan , O'Connell Stephen R , Alexander Judith , Bressler Neil M , Schachat Andrew P , Zeimer Ran 
Published: January 2019

* OBJECTIVE: To evaluate the ability of a retina specialists grading of 30° color stereoscopic fundus photographs to identify areas of significant retinal thickening as assessed by the Retinal Thickness Analyzer (RTA) and to determine whether this ability was affected by the presence of retinal pathology.
* MATERIALS AND METHODS: Thirty-two eyes in 29 patients clinically diagnosed as having diabetic macular edema underwent RTA scanning and nonsimultaneous 30° color stereoscopic fundus photography. Retinal thickness maps of the macular area were generated, and regions with significant retinal thickening (≥2 SD above normal values) were identified. A retina specialist reader, masked to the RTA measurements, identified areas with macular edema on the stereoscopic fundus photographs, which subsequently were overlaid on the retinal thickness maps. The sensitivity (percent of significant retinal thickening areas identified by the retina specialist grading the stereoscopic fiindus photographs) was calculated separately for areas with and without retinal pathology. Specificity of the stereoscopic fundus photograph grading was assessed similarly.
* RESULTS: The retina specialists stereoscopic fundus photography grading identified 78.8% of areas with significant retinal thickening (range over eyes: 20.4%1 00%) and was slightly more likely to identify significant retinal thickening when pathology was present (89.6%) than when pathology was not present (78.4%; pooled risk ratio, 1.14 [95% CI=0.54, 2.42]). Specificity of stereoscopic fundus photography grading was 58%, ie, 42% of areas without significant retinal thickening were (incorrectly) identified as edematous by the stereoscopic fundus photograph grading. This misidentification was more likely if pathology was present (76.9%) than if pathology was not present (41.1%; pooled risk ratio, 1.87 [95% CI= 1.28, 2.73]).
* CONCLUSION: This study shows the determination of macular edema by a retina specialist reading color stereoscopic fundus photographs is sensitive but not specific with reference to edema identified by the RTA, Furthermore, the presence of retinopathy tends to cause false-positive readings with reference to edema identified by the RTA. These findings indicate the need to use objective, quantitative methods in clinical studies to detect and monitor macular edema.
[Ophthalmic Surg Lasers Imaging 2003;34:7-16]
Peripapillary Nerve Fiber Layer Thickness Measurement Reproducibility Using Optical Coherence Tomography
Authors: Villain Max A , Greenfield David S 
Published: January 2019

* OBJECTIVE: To assess reproducibility of quadrantic and clock hour sectors of retinal nerve fiber layer thickness in normal eyes using optical coherence tomography.
* MATERIALS AND METHODS: Normal eyes of healthy volunteers meeting eligibility criteria, were imaged by two inexperienced operators. Six 360° circular scans with a diameter of 3.4 mm centered on the optic disc were obtained during each scanning session, and a baseline image was formed using 3 high-quality images defined by the software. Images were obtained on three different days within a 4-week period. Variance and coefficient of variation (CV) were calculated for quadrantic and retinal nerve fiber layer clock hour sectors obtained from the baseline image.
* RESULTS: Five normal eyes were scanned. Intraoperator reproducibility was high. The mean (±SD) CV for total retinal nerve fiber layer thickness was 5.3±3.82% and 4.33±3.7% for operators 1 and 2, respectively. Interoperator reproducibility was good with statistically similar variance for all quadrantic and clock hour retinal nerve fiber layer parameters (P=.42 to .99), The nasal retinal nerve fiber layer was the most variable sector for both operators (mean CV: 10.42% and 7.83% for operators 1 and 2, respectively). Differences in mean total, nasal, temporal, and superior retinal nerve fiber layer thickness were not statistically significant between operators for all eyes; however, for inferior retinal nerve fiber layer thickness, there was a significant (/^.0007) difference between operators in one eye.
* CONCLUSION: Peripapillary retinal nerve fiber layer thickness assessments using optical coherence tomography have good intraoperator and interoperator reproducibility. Inexperienced operators can generate useful measurement data with acceptable levels of variance.
[Ophthalmic Surg Lasers Imaging 2003:34:33-37]
Normative Retardation Data Corrected For the Corneal Polarization Axis With Scanning Laser Polarimetry
Authors: Greenfield David S , Knighton Robert W , Feuer William J , Shiffman Joyce C 
Published: January 2019

* BACKGROUND AND OBJECTIVE: To evaluate the distribution of retinal nerve fiber layer thickness measurements in normal eyes corrected for corneal polarization axis (CPA).
* METHODS: Complete ocular examination, standard automated perimetry, peripapillary and macular scanning laser polarimetry imaging, and CPA measurements were performed in normal eyes. A noninvasive device mounted on a slit lamp that incorporated two crossed linear polarizers and an optical retarder to measure the slow axis of corneal birefringence was constructed. One eye per patient was enrolled. Exclusion criteria consisted of visual acuity of less than 20/40, a refractive error exceeding ± 5.0 diopter sphere, 2.0 diopter cylinder, or both, previous intraocular surgery, or ocular disease except cataract. According to scanning laser polarimetry, peripapillary retardation parameters within 90% normal limits were recorded as "normal," parameters outside 95% normal limits were recorded as "abnormal," and parameters between 90% and 95% limits were recorded as "borderline."
* RESULTS: Fifty-one eyes of 51 subjects (14 men, 37 women) were enrolled (mean age, 51 ± 17 years). Prediction limits (± 2 standard deviation outside of regression line) were calculated for 14 peripapillary retardation parameters. The prediction limits of the average thickness of the retinal nerve fiber layer (µm) were reduced 35% by correction of the CPA; for ellipse average (µm), the limits were reduced 33%. Sixteen of 51 normal eyes (31%) had at least one abnormal retardation parameter, and among these 16 eyes there was a bimodal distribution of CPA values (0° to 20° nasally downward, 60° to 80° nasally downward).
* CONCLUSIONS: Correction for CPA reduces the variance of normal retardation measurements. Normal eyes with a CPA of 0° to 20° nasally downward and 60° to 80° nasally downward were characterized by "abnormal" summary retardation parameters as interpreted by scanning laser polarimetry.
[Ophthalmic Surg Lasers Imaging 2003;34:165-171.]
Evaluation of Hydroxychloroquine Retinopathy With Multifocal Electroretinography
Authors: So Scott C , Hedges Thomas R , Schuman Joel S , Quireza Maria Luz Amaro 
Published: January 2019

* BACKGROUND AND OBJECTIVE: To describe the changes revealed by multifocal electroretinography (ERG) in patients taking hydroxychloroquine.
* PATIENTS AND METHODS: Six patients being treated for various inflammatory conditions with hydroxychloroquine for periods ranging from 8 months to 7 years were consecutively evaluated. Each examination included measurement of Snellen visual acuities, Amsler grid assessment, and automated visual field testing. In some cases, funduscopic examinations were complimented by photography and fluorescein angiography. Multifocal ERG was performed for all patients.
* RESULTS: Three patients (six eyes) were found to have distinctive abnormalities on multifocal ERG consisting of pericentral depression of ERG signals. The abnormalities on multifocal ERG corresponded with the patients' subjective descriptions and the visual field depiction of their pericentral scotomas. All affected patients had been taking hydroxychloroquine for at least 7 years. One patient with generalized depression on multifocal ERG had possible hydroxychloroquine retinopathy. Two patients (three eyes) had relatively normal results on multifocal ERG.
* CONCLUSION: Multifocal ERG objectively demonstrates depression of signals in the perifoveal region in visually symptomatic patients with longterm hydroxychloroquine use. Even patients with normal visual acuity and no fundus abnormalities can have abnormal results. Although we have not yet identified patients with abnormalities on multifocal ERG before the onset of symptoms, multifocal ERG may be useful in monitoring patients at risk and may provide an earlier opportunity to identify maculopathy.
[Ophthalmic Surg Lasers Imaging 2003;34:251-258.]
Phacoemulsification Cataract Extraction and Intraocular Lens Implantation in Patients With Behçet's Disease
Authors: Berker Nilufer , Soykan Emel , Elgin Ufuk , Ozkan Seyhan Sonar 
Published: January 2019

* BACKGROUND AND OBJECTIVE: To evaluate the outcomes of phacoemulsification cataract extraction and intraocular lens implantation in patients with Behcet's disease.
* PATIENTS AND METHODS: This prospective study was based on 40 eyes of 34 patients with Behcet's disease who underwent phacoemulsification cataract extraction and intraocular lens implantation between May 2000 and February 2003. Their postoperative ocular complications and visual outcomes were observed during a mean follow-up period of 18.35 ± 6.17 months (range, 6 to 32 months).
* RESULTS: Postoperative visual acuity increased in 29 eyes (72.5%) and was 20/40 or better in 18 eyes (45%). It decreased in 7 eyes (17.5%), resulting in a visual acuity of 20/400 or worse. The most frequent postoperative complication was posterior capsular opacification, which developed in 15 eyes (37.5%). Other complications were posterior synechiae formation in 7 eyes (17.5%), severe inflammation in 5 eyes (12.5%), cystoid macular edema in 5 eyes (12.5%), epiretinal membrane in 3 eyes (7.5%), and optic atrophy in 2 eyes (5%).
* CONCLUSION: With appropriate preoperative and postoperative suppression of inflammation, phacoemulsification and intraocular lens implantation are safe procedures leading to visual improvement in patients with Behcet's disease without preexisting fundus lesions.
[Ophthalmic Surg Lasers Imaging 2004;35:215-218.]
Anatomic and Visual Acuity Outcomes Following Thermal Laser Photocoagulation or Photodynamic Therapy for Symptomatic Circumscribed Choroidal Hemangioma With Associated Serous Retinal Detachment
Authors: Scott Ingrid U , Gorscak Jason , Gass J Donald M , Feuer William J , Murray Timothy G 
Published: January 2019

* BACKGROUND AND OBJECTIVE: This study reports and compares the anatomic and visual acuity outcomes of patients treated with either thermal laser photocoagulation or photodynamic therapy for circumscribed choroidal hemangioma with associated serous retinal detachment.
* PATIENTS AND METHODS: Retrospective, consecutive, interventional case series of patients treated for symptomatic circumscribed choroidal hemangioma.
* RESULTS: Thirteen of 23 patients (57%) treated with thermal laser photocoagulation exhibited complete resolution of subretinal fluid, 6 (26%) had partial resolution of subretinal fluid, and 4 (17%) had persistent subretinal fluid despite therapy. At 3 months posttreatment, visual acuity was improved in 6 (26%), stable in 13 (57%), and worsened in 4 (17%) of 23 patients. All 5 patients who underwent photodynamic therapy had complete resolution of subretinal fluid. At 3 months posttreatment, visual acuity improved in 4 (80%), remained stable in 1 (20%), and worsened in 0 (0%) patients.
* CONCLUSIONS: Photodynamic therapy shows similar if not better anatomic and visual acuity results than thermal laser photocoagulation when treating symptomatic circumscribed choroidal hemangioma.
[Ophthalmic Surg Lasers Imaging 2004;35:281-291.]
A Novel High-Resolution Kinetic Method for Visual Field Mapping of Scotoma in Age-Related Macular Degeneration
Authors: Zur Dror , Simon Guy J Ben , Loewenstein Anat , Alster Yair , Moisseiev Joseph , Ullman Shimon 
Published: January 2019

* BACKGROUND AND OBJECTIVE: To exam ine a new high-resolution kinetic mapping method for scotoma in age-related macular degeneration.
* PATIENTS AND METHODS: A computer-based program for kinetic visual field mapping was tested in IO healthy subjects and 14 patients with age-related macular degeneration and fixed preferred retinal locus. The stimulus was presented using a back projector on a screen located 40 cm from the subject. The findings were then compared with static results.
* RESULTS: Control group mapping revealed good congruency with the anatomic blind spot. Mapping of the 14 patients with age-related macular degeneration was rapid and revealed good accuracy. The average deviation of the mapping border from the anatomic scotoma border was no more than 3.1% of the scotoma radius. Static mapping of 7 of the patients with age-related macular degeneration was longer and revealed lower accuracy.
* CONCLUSIONS: The proposed method is more rapid, accurate, and consistent than static mapping. It allows accurate mapping of central scotoma with suprathreshold stimulus, and may be used in the future for detecting the early stages of age-related macular degeneration using subthreshold stimulus.
[Ophthalmic Surg Lasers Imaging 2004:35:395-405.]
Feasibility of Noninvasive Imaging of Chorioretinal Oxygenation
Authors: Shahidi Mahnaz , Blair Norman P , Mori Marek , Zelkha Ruth 
Published: January 2019

* BACKGROUND AND OBJECTIVE: The feasibility of an optical system for noninvasive imaging of chorioretinal oxygénation was evaluated. Due to its depth discrimination, this optical section imaging technique has potential for differential imaging of oxygen tension in the chorioretinal vasculatures.
* MATERIALS AND METHODS: The method consisted of projecting a narrow laser line obliquely on the retina after intravenous injection of an oxygen-sensitive probe and imaging the phosphorescence emission. Due to the angle between the incident laser and imaging path, a phosphorescence optical section image of the retina was captured. The phosphorescence intensity was measured in the chorioretinal vasculatures. The method was tested in three rats while breathing 10% oxygen, 50% oxygen, and room air.
RESULTS: On the phosphorescence optical section image, vasculatures appeared laterally displaced according to their depth location, displaying probe phosphorescence separately in the chorioretinal vasculatures. Oxygénation increased in all vasculatures with increased inhaled percent oxygen. Oxygénation in the retinal artery was 2.3, 1.9, and 1.6 times oxygénation in the retinal vein, capillary, and choroid, respectively. During hypoxia, oxygénation decreased by 28%, 18%, 22%, and 14% in the retinal vein, artery, capillary, and choroid, respectively. During hyperoxia, oxygénation increased by 30%, 45%, 36%, and 28% in the retinal vein, artery, capillary, and choroid, respectively.
* CONCLUSION: The results demonstrate the feasibility of this technique for noninvasive and separate imaging of chorioretinal oxygénation and its potential for three-dimensional oxygen tension imaging.
[Ophthalmic Suig Lasers Imaging 2004;35:4l5-422.]
Health Literacy and Cervical Cancer Screening Among Mexican-American Women
Authors: Flores Bertha E. , Acton Gayle , Arevalo-Flechas Lyda , Gill Sara , Mackert Michael 
Published: January 2019

Background:Health literacy is a requisite skill for making personal health and health care decisions. Low health literacy may contribute to lower cervical cancer screening rates and cervical cancer health disparities among Mexican-American women in South Texas.Objective:To explore older Mexican-American women's health literacy related to cervical cancer from the perspective of Zarcadoolas, Pleaseant, and Greer's health literacy model.Methods:We conducted five focus groups and seven individual interviews with 30 Mexican and Mexican-American women in South Texas. We analyzed demographic data using descriptive statistics and conducted thematic analysis of focus group and individual interview data.Key Results:Several themes reflected the domains of health literacy, including fundamental literacy (“speaking of language”), science literacy (cancer prevention), cultural literacy (“we are different”), civic literacy (the availability of “consejos” [advice]), and media literacy (e.g., “telenovelas” [soap-operas] teach a lot). In this article, we present findings related to culture and language under the domains of fundamental and cultural literacy.Conclusions:Mexican-American women's cultural values and language use may serve as both deterrents and incentives to cervical cancer screening. The meaning of words can be lost in translations. Health care providers can use this information to provide cervical cancer screening education congruent with Mexican-American's culture, language, and code switching.[HLRP: Health Literacy Research and Practice. 2019;3(1):e1–e8.]Plain Language Summary:The understanding of culture and language can help health care providers improve cervical cancer screening practices among Mexican-American women. The results from this study can be used to individualize patient care and to develop education and communication strategies that are similar to the population we serve, including Mexican-American women.
Expérience, idéaux et participation sociale
Authors: Lamine Anne-Sophie 
Published: January 2019

Cet article discute la pertinence de plusieurs textes de Dewey, Le public et ses problèmes (1927), Ethics (1932), « Théorie de la valuation » (1939), L’art comme expérience (1934) et Une foi commune (1934), pour l’analyse sociologique du religieux dans un contexte de pluralité et d’inquiétude sur les identités. Ce pragmatisme permet d’aborder le religieux en acte, l’expérience et la construction de soi, en ne négligeant pas les affects. Il fournit un concept d’idéal, faisant part à l’intersubjectivité et au contexte, permettant traiter du dépassement de soi. Enfin, Il éclaire la notion de commun, y compris construit à partir d’identités particulières, et nous fait préférer le concept pratique participation sociale à celui d’intégration.
The importance of appropriate reporting and investigation of incidental findings on computed tomography attenuation correction images during myocardial perfusion scintigraphy
Authors: Delaney Francis T , Gray Emma L , Lee Joseph C 
Published: January 2019

AbstractWe present a case of lung cancer incidentally detected as a pulmonary nodule on computed tomography attenuation correction (CTAC) images during myocardial perfusion scintigraphy (MPS). Unfortunately, the incidental lesion was not fully investigated following MPS report and had developed into metastatic lung carcinoma when diagnosed over 1 year later, with failure of subsequent emergent chemotherapy. The disease appeared to be localized when initially detected during MPS. This case highlights the importance and potential clinical value of routine review of CTAC images in MPS with appropriate reporting and further investigation of suspicious incidental findings. In addition, the importance of effective communication between nuclear medicine department and treating team is clear to ensure suspicious incidental findings are given sufficient credence and thoroughly investigated promptly to avoid adverse clinical outcomes.
Tumor volume delineation: A pilot study comparing a digital positron-emission tomography prototype with an analog positron-emission tomography system
Authors: Nguyen Nghi C. , Vercher-Conejero Jose , Faulhaber Peter 
Published: January 2019

AbstractWe evaluated the potential differences of a digital positron-emission tomography (PET) prototype equipped with photon-counting detectors (D-PET, Philips Healthcare, Cleveland, Ohio, USA) in tumor volume delineation compared with the analog Gemini TF PET system (A-PET, Philips). Eleven oncologic patients first underwent clinical fluorodeoxyglucose (FDG) PET/computed tomography (CT) on A-PET. The D-PET ring was then inserted between the PET and CT scanner of A-PET and the patient was scanned for the second time. Two interpreters reviewed the two sets of PET/CT images for image quality and diagnostic confidence. FDG avid lesions were evaluated for volume measured at 35% and 50% of maximum standard uptake value (SUV) thresholds (35% SUV, 50% SUV), and for SUV gradient as a measure of lesion sharpness. Bland–Altman plots were used to assess the agreement between the two PET scans. Qualitative lesion conspicuity, sharpness, and diagnostic confidence were greater at D-PET than that of A-PET with favorable inter-rater agreements. Median lesion size of the 24 measured lesions was 1.6 cm. The lesion volume at D-PET was smaller at both 35% SUV and 50% SUV thresholds compared with that of A-PET, with a mean difference of − 3680.0 mm3 at 35% SUV and − 835.3 mm3 at 50% SUV. SUV gradient was greater at D-PET than at A-PET by 49.2% (95% confidence interval: 34.1%–60.8%). Given the smaller volume definition, coupled with improved conspicuity and sharpness, digital PET may be more robust and accurate in tumor rendering compared with analog PET not only for radiotherapy planning but also in prognostication and systemic treatment monitoring.
Flipping the Classroom in Graduate Medical Education: A Systematic Review
Authors: King Andrew M. , Gottlieb Michael , Mitzman Jennifer , Dulani Tina , Schulte Stephanie J. , Way David P. 
Published: January 2019

ABSTRACT

Background
Flipped classroom (FC) instruction has become increasingly common in graduate medical education (GME).

Objective
The purpose of this study was to profile the use of FC in the GME setting and assess the current status of research quality.

Methods
We conducted a systematic literature search of major health and social science databases from July 2017 to July 2018. Articles were screened to ensure they described use of the FC method in an Accreditation Council for Graduate Medical Education–accredited residency program and included research outcomes. Resulting articles were analyzed, described, and evaluated for research quality using the Kirkpatrick framework and the Medical Education Research Study Quality Instrument (MERSQI).

Results
Twenty-two articles were identified, all of which were recently published. Five were only indirectly related to FC methods. Most studies reported Kirkpatrick-level outcomes. Studies involving resident learner opinions were generally positive. Pre-posttest studies resulted in large positive improvements in knowledge or skills attainment. Control group study results ranged from large positive (1.56) to negative effects (–0.51). Average MERSQI scores of 12.1 (range, 8.5–15.5) were comparable to GME research norms.

Conclusions
Varying methods for implementing and studying the FC in GME has led to variable results. While residents expressed a positive attitude toward FC learning, shortcomings were reported. Approximately half of the studies comparing the flipped to the traditional classroom reported better achievement under the FC design. As indicated by the MERSQI score, studies captured by this review, on average, were as rigorous as typical research on residency education.