bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validity of Algorithms to Identify Patients With Glaucoma Using the Japanese Claims Data
Authors: Fujita Asahi , Aoyama Yurika , Yamana Hayato , Konishi Takaaki , Hashimoto Yohei , Aihara Makoto , Yasunaga Hideo 
Published: February 2023

Précis:
Diagnostic or antiglaucoma drug records in the Japanese claims data showed a high validity in identifying glaucoma patients. Specific subtypes were identified with high specificity and negative predictive values but low sensitivity and positive predictive values.

Purpose:
Despite the widespread use of administrative claims data in epidemiological research on glaucoma, only a few studies have investigated the validity of the methods in defining patients with glaucoma using diagnoses and drug records. We aimed to evaluate the validity of these algorithms in identifying patients with glaucoma using the Japanese claims data.

Methods:
Two ophthalmologists independently reviewed the medical charts and administrative claims data of 500 randomly selected patients who visited the Department of Ophthalmology of an academic hospital in 2019. We constructed 12 algorithms to identify patients with any type and specific subtypes of glaucoma using the claims records of diagnosis, antiglaucoma drugs, and visual field tests. We regarded the diagnosis of glaucoma based on the medical charts as the reference standard and calculated the sensitivity, specificity, and positive and negative predictive values of each algorithm based on the claims data.

Results:
The algorithms of ≥1 diagnostic record per year and ≥1 antiglaucoma drug record per year exhibited sensitivities of 94.6% and 89.2%, respectively, and specificities of 88.9% and 98.3%, respectively. An increase in the frequency of records resulted in a decreased sensitivity and slightly increased specificity. The addition of visual field tests did not improve the validity. The algorithms for specific subtypes of glaucoma exhibited high specificity and relatively low sensitivity.

Conclusion:
Diagnostic or antiglaucoma drug records in the Japanese claims data were useful for identifying patients with glaucoma. Researchers should select identification algorithms based on the study design.
Quantification of Hypotony Maculopathy Using Spectral-Domain Optical Coherence Tomography
Authors: Dumas Rémy , Lacourse Magaly , Kassem Rabea , Lesk Mark R. , Costantino Santiago 
Published: February 2023

Précis:
We provide a free-to-use, open-source algorithm to quantify macular hypotony based on optical coherence tomography (OCT) images. This numerical approach calculates a metric that measures the deviations of Bruch’s membrane from a smooth ideal retinal layer.

Purpose:
Hypotony maculopathy is a recurrent complication of glaucoma surgical interventions in which extremely low intraocular pressure triggers changes in the shape of retinal layers. Abnormal folds can often be observed in the retina using standard fundoscopy, but OCT is particularly important to appreciate the severity of symptoms at different depths. Despite the need for metrics that could be used for the informed clinical decision to evaluate the progression and resolution of macular hypotony, algorithms that quantify the retinal folds are not available in the literature or included in clinical imaging equipment. The purpose of this work is to introduce a simple algorithm that can be used to assess hypotony maculopathy from OCT B-Scans and volumes and a free, open-source implementation.

Methods:
The pipeline we present is based on a straightforward segmentation of Bruch’s membrane complex. The principal idea of quantification is to compute a smoothed version of this complex and analyze the deviations from an ideal interface. Such deviations are then measured and added to create a metric that characterizes each OCT B-Scan. A full OCT volume reconstruction is thus characterized by the average metric obtained from all planes.

Results:
We tested the metric we proposed against the assessment of 3 experts and obtained a very good correspondence, with Pearson correlation coefficients higher than 0.8. Furthermore, agreement with automatic analysis seemed better than between experts. We describe the pipeline in detail and illustrate the results with a group of patients, comparing baseline images, severe hypotony maculopathy, and a variety of outcomes.

Conclusion:
The tool we introduce and openly provide fills a clinical gap to quantitatively grade hypotony maculopathy. It offers a metric of relatively simple interpretation that can be used to help clinicians in cases where the regression of symptoms is not obvious to the naked eye. Our pilot study demonstrates reliable results, and an open-source implementation facilitates easy improvements to our algorithm.
Influence of 0.002% Omidenepag Isopropyl on Intraocular Pressure and the Cornea in Normal Tension Glaucoma
Authors: Lee Seung Hyeun , Lee Won Jun , Kim Kyoung Woo , Jeong Jae Hoon , Park In Ki , Chun Yeoun Sook 
Published: February 2023

Précis:
Although Omidenepag isopropyl drops elicited stable intraocular pressure reductions in NTG patients, transient changes in refraction and corneal endothelial cells, significant increase of central corneal thickness, and corneal erosion should be considered.

Purpose:
To analyze the efficacy and safety of 0.002% omidenepag Isopropyl (OMDI) eye drops in patients with normal tension glaucoma (NTG).

Methods:
Medical records for 62 eyes treated with OMDI for ≥6 months were analyzed. Intraocular pressure (IOP), refraction, keratometry, central corneal thickness (CCT), endothelial cell count, coefficient of variation of endothelial cell area (CV), corneal erosion, and central retinal thickness were compared at baseline and 1, 3, and 6 months.

Results:
IOP significantly decreased from 13.4±3.8 to 11.9±3.0, 11.7±2.9, and 12.2±3.3 mm Hg at each follow-up (P<0.001). Endothelial cell count did not change, but CV transiently increased from 12.6 to 17.0 at 1 month, CCT increased from 531.5 to 538.4 μm, myopia changed from −1.5 to −1.9 D, and keratometry changed from 44.5 to 44.7 D. CV, myopia, and keratometry recovered to baseline at 6 months; however, CCT remained high. Significant corneal erosion was observed at 6 months. Central retinal thickness changes were not observed. There were improvements in prostaglandin-associated skin pigmentation (86.7%), eyelash elongation (40.0%), and deepening of the upper eyelid sulcus and ptosis (~30%) at 3 months after exchange to OMDI. Adverse reactions were corneal erosion (27.4%), corneal thickening (21.0%), conjunctival hyperemia (11.3%), photophobia (5.7%), blurred vision (5.7%), and anterior chamber cells (4.8%).

Conclusions:
OMDI eye drops elicited significant and stable IOP reductions after 6 months in NTG patients with low IOP. However, transient myopic and corneal endothelial cell changes, development of corneal thickening, and corneal erosion should be considered when using OMDI.
Acute and Postacute Clinical Characteristics of Coronavirus Disease 2019 in Children in Japan
Authors: Katsuta Tomohiro , Aizawa Yuta , Shoji Kensuke , Shimizu Naoki , Okada Kenji , Nakano Takashi , Kamiya Hajime , Amo Kiyoko , Ishiwada Naruhiko , Iwata Satoshi , Oshiro Makoto , Okabe Nobuhiko , Korematsu Seigo , Suga Shigeru , Tsugawa Takeshi , Nishimura Naoko , Hishiki Haruka , Fujioka Masashi , Hosoya Mitsuaki , Mizuno Yumi , Miyairi Isao , Miyazaki Chiaki , Morishima Tsuneo , Yoshikawa Tetsushi , Wada Taizo , Ouchi Kazunobu , Moriuchi Hiroyuki , Tanaka-Taya Keiko , Saitoh Akihiko 
Published: February 2023

Background:
The clinical features of coronavirus disease 2019 (COVID-19) in children have been changing because of the emergence and rapid spread of variants of concern (VOC). The increase in cases infected with VOC has brought concern with persistent symptoms after COVID-19 in children. This survey aimed to analyze the clinical manifestations and persistent symptoms of pediatric COVID-19 cases in Japan.

Methods:
We analyzed the clinical manifestations of pediatric COVID-19 cases reported between February 2020 and April 2022 in Japan, using a dedicated database updated voluntarily by the members of the Japan Pediatric Society. Using the same database, we also analyzed persistent symptoms after COVID-19 in children who were diagnosed between February 2020 and November 2021.

Results:
A total of 5411 and 1697 pediatric COVID-19 cases were included for analyzing clinical manifestations and persistent symptoms, respectively. During the Omicron variant predominant period, the percentage of patients with seizures increased to 13.4% and 7.4% in patient groups 1–4 and 5–11 years of age, respectively, compared with the pre-Delta (1.3%, 0.4%) or Delta period (3.1%, 0.0%). Persistent and present symptoms after 28 days of COVID-19 onset were reported in 55 (3.2%).

Conclusions:
Our survey showed that the rate of symptomatic pediatric COVID-19 cases increased gradually, especially during the Omicron variant predominant period, and a certain percentage of pediatric cases had persistent symptoms. Certain percentages of pediatric COVID-19 patients had severe complications or prolonged symptoms. Further studies are needed to follow such patients.
Multiple MIS-C Readmissions and Giant Coronary Aneurysm After COVID-19 Illness and Vaccination: A Case Report
Authors: Haq Khadija , Anyalechi E. Gloria , Schlaudecker Elizabeth P. , McKay Rachel , Kamidani Satoshi , Manos Cynthia K. , Oster Matthew E. 
Published: February 2023

Background:
Multisystem inflammatory syndrome in children (MIS-C) rarely involves delayed giant coronary aneurysms, multiple readmissions or occurrence after COVID-19 vaccination.

Methods:
We describe a child with all 3 of these unusual features. We discuss his clinical presentation, medical management, review of the current literature and CDC guidance recommendations regarding further vaccinations.

Results:
A 5-year-old boy had onset of MIS-C symptoms 55 days after COVID-19 illness and 15 days after receiving his first BNT162b2 COVID-19 vaccination. He was admitted 3 times for MIS-C, and twice after his steroid dose was tapered. On his initial admission, he was given intravenous immunoglobulin and steroids. During his second admission, new, moderate coronary dilation was noted, and he was treated with intravenous immunoglobulin and steroids. At his last admission, worsening coronary dilation was noted, and he was treated with infliximab and steroids. During follow-up, he had improvement in his coronary artery dilatation. However, his inflammatory markers increased after steroid wean, and his steroid taper was further extended, after which time his inflammatory markers improved. This is the only such reported case of a patient who was admitted 3 times for MIS-C complications after COVID-19 vaccination.

Conclusion:
MIS-C rarely involves delayed giant coronary aneurysms, multiple readmissions, or occurrence after COVID-19 vaccination. Whether our patient’s COVID-19 vaccine 6 weeks after COVID-19 illness contributed to his MIS-C is unknown. After consultation with the CDC-funded Clinical Immunization Safety Assessment Project, the patient’s care team decided against further COVID-19 vaccination until at least 3 months post normalization of inflammatory markers.
Routine Immunization Coverage and Immunization Card Retention in Pakistan: Results From a Cross-sectional National Survey
Authors: Hussain Imtiaz , Khan Ahmad , Rhoda Dale A. , Ahmed Imran , Umer Muhammad , Ansari Uzair , Shah Muhammad Akram , Yunus Soofia , Brustrom Jennifer , Oelrichs Robert , Soofi Sajid Bashir , Bhutta Zulfiqar A 
Published: February 2023

Background:
Immunization is one of the most successful public health interventions available, saving millions of lives from death and disability each year. Therefore, improving immunization coverage is a high priority for the Government of Pakistan and essential to progress toward universal health coverage. This survey reports the national and provincial/regional coverage and determinants of fully, partially, and not-vaccinated children 12–23 months of age, antigen-wise coverage, percentage of home-based vaccination records (HBR) retention, and reasons for nonretention; dropout, timeliness, and prevalence of missed opportunities for simultaneous vaccination (MOSV).

Methods:
The survey was a descriptive cross-sectional national household survey carried out across Pakistan. The survey included 110,790 children 12–23 months old and their caregivers. A World Health Organization (WHO)—Expanded Program on Immunization (EPI) Survey questionnaire was adapted to collect information. Data were analyzed using the WHO Vaccination Coverage Quality Indicators (VCQI) software and Stata version 17.

Results:
Nationally excluding Azad Jammu and Kashmir (AJK) and Gilgit Baltistan (GB), the coverage of fully vaccinated children was 76.5%. The likelihood of being fully vaccinated was higher among children of educated parents who belonged to higher wealth quintiles and resided in any province/region other than Balochistan. The main reasons for unimmunization were no faith in immunization, rumors about vaccines, and distance to the facility. About two-thirds (66.2%) of the children had their HBR available, and the main reasons for not having a card were never visiting a health facility and having no awareness about the importance of a card. Dropout was discernible for later doses of vaccines compared with earlier ones. Higher proportions of children received the last doses late by more than two months. Of the 218,002 vaccination visits documented on HBR in the provinces, MOSVs occurred in 17.6% of the visits.

Conclusion:
The immunization coverage rates provide a direction to strategize the progress to improve the vaccination rates in Pakistan. The country needs to outline the immediate and long-term actions to combat vaccine-preventable diseases, such as escalating integrated immunization campaigns and outreach activities, provision of mobility support, and deploying behavioral interventions as a cross-cutting strategy to improve awareness and reduce misconceptions.
Central Nervous System Coccidioidomycosis in Children: A Retrospective Case Series
Authors: Naeem Fouzia , Laningham Fred , Giglio Linda , Sharma Julia , Clerkin Patricia Quebada , McCarty James M. 
Published: February 2023

Background:
Published literature on central nervous system (CNS) coccidioidomycosis in children is limited. Here we describe a large case series of pediatric CNS coccidioidomycosis from a tertiary care center in an endemic region.

Method:
This is a retrospective case review of patients ≤21 years old with a diagnosis of CNS coccidioidomycosis from January 1, 2000, to December 31, 2018.

Results:
Thirty patients (median age 10.8 years) were identified and most (93%) were previously healthy. Fever (90%), headache (70%), vomiting (53%), and fatigue (57%) were the most common presenting clinical manifestations, with focal neurological signs/symptoms present in 14 (47%). The initial serum Coccidioides compliment fixation (CF) titer was ≤ 1:8 in 33%. Most patients had extra-axial brain involvement (83%) and seven (23%) had associated spinal cord disease. Shunt placement was required in 70% and 62% required revision. Fluconazole was the initial treatment in 22 (73%), with treatment failure occurring in 50%. Most patients (77%) stabilized and were maintained on suppressive therapy, 4 (13%) experienced relapses and/or progressive disease, and one (3%) died, while long-term neurological complications occurred in 17%.

Conclusions:
CNS coccidioidomycosis is an uncommon and sometimes devastating complication of disseminated coccidioidomycosis. Many patients present with relatively low CF titers and hydrocephalus is common. Fluconazole treatment failures are common, and management remains difficult despite recent advances in therapy. Most patients do well once the disease is stabilized and require lifelong therapy. Newer therapeutic agents are needed.
Evaluation of a visual acuity eHealth tool in patients with cataract
Authors: Wanten Joukje C. , Bauer Noël J.C. , Claessens Janneau L.J. , van Amelsfort Thomas , Berendschot Tos T.J.M. , Wisse Robert P.L. , Nuijts Rudy M.M.A. 
Published: February 2023

Purpose:
To validate the Easee web-based tool for the assessment of visual acuity in patients who underwent cataract surgery.

Setting:
University Eye Clinic Maastricht, Maastricht, the Netherlands.

Design:
Prospective method comparison study.

Methods:
Subjects aged between 18 and 69 years who underwent cataract surgery on 1 or both eyes at the Maastricht University Medical Center+ were eligible to participate in this study. The uncorrected (UDVA) and corrected distance visual acuity (CDVA) assessments were performed using the web-based tool (index test) and conventional ETDRS and Snellen charts (reference tests). The outcomes of the different tests were expressed in logMAR, and a difference of <0.15 logMAR was considered clinically acceptable.

Results:
46 subjects with 75 operated eyes were included in this study. The difference of the UDVA between the web-based tool and ETDRS or Snellen was −0.05 ± 0.10 logMAR (P < .001 [0.15; −0.26]) and −0.04 ± 0.15 logMAR (P = .018 [0.24; −0.33]), respectively. For the CDVA, these differences were −0.04 ± 0.08 logMAR (P < .001 [0.13; −0.21]) and −0.07 ± 0.10 logMAR (P < .001 [0.13; −0.27]), respectively. The Pearson correlation coefficients between the web-based tool and ETDRS were maximally 0.94 and compared with Snellen 0.92. In total, 73% to 88% of the visual acuity measurement differences were within 0.15 logMAR.

Conclusions:
The web-based tool was validated for the assessment of visual acuity in patients who underwent cataract surgery and showed clinically acceptable outcomes in up to 88% of patients. Most of the participants had a positive attitude toward the web-based tool, which requires basic digital skills.
Ten-year outcomes of pseudophakic mini-monovision correction of hyperopic presbyopia
Authors: Wróbel-Dudzińska Dominika , Moura-Coelho Nuno , Palma-Carvajal Francisco , Zebdeh Abdulah , Manero Felicidad , Güell José Luis 
Published: February 2023

Purpose:
To evaluate long-term efficacy, safety, and spectacle independence after the treatment of hyperopic presbyopia with pseudophakic mini-monovision using standard monofocal intraocular lenses (IOLs) after bilateral cataract surgery.

Setting:
Private practice in Barcelona, Spain.

Design:
Retrospective, noncomparative case series.

Methods:
Patients with hyperopic presbyopia underwent bilateral cataract surgery with pseudophakic mini-monovision using standard monofocal IOLs between 2008 and 2018. Main outcomes analyzed were uncorrected distance visual acuity (UDVA), uncorrected near distance visual acuity (UNVA), and rates of spectacle independence at postoperative day 1 (POD1), months 1, 6 and 12, and at 5 and 10 years (Y10) postoperatively.

Results:
The study enrolled 463 patients. Both UDVA and UNVA significantly improved postoperatively (P < .05). The mean binocular UDVA improved from 0.47 ± 0.3 logMAR preoperatively to 0.096 ± 0.14 at POD1 to 0.16 ± 0.2 at Y10 (P = .0033). The binocular UNVA was 0.05 logMAR at Y10, whereas in preoperative visits, all patients needed spectacles. The mean UDVA for the dominant eye ≤0.20 logMAR was achieved in 84.29% at the Y10. Self-reported and measured complete spectacle independence for near vision was achieved in 79.61% of patients at POD1 and 71.92% at Y10 postoperatively. For distance, respectively, in 86.29% of patients at POD1 and 78.43% at Y10. The achieved results were stable. No serious events were reported, as well as no photic phenomena.

Conclusions:
Pseudophakic mini-monovision in hyperopic presbyopes is a safe, effective, and low-cost approach for the long-term correction of presbyopia. It significantly reduces spectacle dependence and fulfils patients' expectations after bilateral cataract surgery.
Comparison of the New Hoffer QST with 4 Modern Accurate Formulas.
Authors: Taroni Leonardo , Hoffer Kenneth J , Pellegrini Marco , Lupardi Enrico , Savini Giacomo 
Published: February 2023

ABSTRACT

Purpose:
To investigate the new Hoffer QST (Savini/Taroni) formula (HQST) and compare it to the original Hoffer Q (HQ) and 4 latest generation formulas.

Setting:
I.R.C.C.S. - G.B. Bietti Foundation, Rome

Design:
Retrospective case series

Methods:
Refractive outcomes of the HQST, Barrett Universal II (BUII), EVO 2.0, HQ, Kane and RBF 3.0 formulas were compared. Subgroup analysis was performed in short (<22 mm) and long (>25 mm) axial length (AL) eyes. The standard deviation (SD) of the prediction error (PE) was investigated using the heteroscedastic method.

Results:
A Caucasian group of eyes (n = 696), implanted with the AcrySof SN60AT (Alcon Labs), and an Asian group (n =563), implanted with the AcrySof SN60WF (Alcon Labs), were investigated. In the Caucasian group, the SD of the EVO (0.464 D), HQST (0.471 D) and Kane (0.474 D) formulas was significantly lower compared to that of the BUII (0.538 D), HQ (0.535 D) and RBF (0.503 D). In the Asian group, the heteroscedastic method did not disclose any significant difference among the SD of the 4 modern formulas (range from 0.333 to 0.346 D), whereas the SD of the HQ formula (0.384 D) was significantly higher.
Compared to the original HQ, in both Caucasian and Asian groups, the HQST avoided the mean myopic PE in short eyes and the mean hyperopic PE in long eyes.

Conclusions:
The new HQST was superior to the original HQ and reached statistical and clinical results comparable to those achieved by the BUII, EVO, Kane and RBF formulas.
Efficacy and tolerability of 0.1% adapalene with 1% clindamycin versus 0.1% adapalene with 2.5% benzoyl peroxide in the treatment of acne vulgaris
Authors: Inbamani Annie Priya Dharshini , Manickam Navakumar , Gopalan Kannan 
Published: February 2023

Objective:
To compare the efficacy and tolerability of 0.1% adapalene with 1% clindamycin versus 0.1% adapalene with 2.5% benzoyl peroxide (BPO) in the treatment of acne vulgaris.

Methods:
This study was conducted over a period of 1 year at our dermatology outpatient department. All patients aged 14 to 30 years with mild to moderate acne vulgaris were included.

Results:
One-hundred patients with mild to moderate acne vulgaris were randomly allocated to two equal groups (n=50 in each group). The patients received a topical combination of 0.1% adapalene with 1% clindamycin and topical combination of 0.1% adapalene with 2.5% BPO, respectively. After 12 weeks of treatment, there were no significant differences between the adapalene-clindamycin and adapalene-BPO groups in the mean reductions in the numbers of non-inflammatory lesions (11.16 ± 8.01 and 11.12 ± 8.62,respectively), inflammatory papules (49.78 ± 37.57 and 50.48 ± 36.57,respectively), and total lesions(67.5 ± 44.59 and 70.12 ± 46.83,respectively). The incidence of a burning sensation was significantly greater in the adapalene-BPO group than the adapalene-clindamycin group (32% versus 6%;P = 0.002).

Conclusion:
Topical adapalene plus clindamycin and adapalene plus BPO had similar efficacies in the treatment of acne. Adapalene with clindamycin was better tolerated than adapalene with BPO.